International Efforts Research Articles

More than medicine: antimicrobial resistance (AMR) as a social and political challenge that can be overcome

ABSTRACT Growing antimicrobial resistance (AMR) threatens modern medicine and global food security through the gradual loss of effective antibiotics and other crucial drugs and chemicals. This dispiriting but inexorable development presents daunting social and political challenges because it arises from how drugs are produced and people everywhere in the world use them. Results of monumental international efforts led by United Nations and European Union bodies to create common purpose and concerted actions against AMR since the early 2010s are so far discouraging. Declarations and plans have proliferated. But social factors such as national and local politics have stymied effective action. Nevertheless, countries in Europe demonstrate that AMR mitigation is politically possible. This article draws on contributions to the SI on AMR politics and governance to illustrate how. Specific institutional arrangements, cultural values, and leadership commitments have had strong impacts on the degree of success of AMR policies. In turn, these factors represent important political conditions that some policymakers have successfully navigated. Hence, the SI’s contributions can offer policy leaders and entrepreneurs clues for domestic and local political efforts to control AMR.

GestaltMatcher Database - A global reference for facial phenotypic variability in rare human diseases.

The most important factor that complicates the work of dysmorphologists is the significant phenotypic variability of the human face. Next-Generation Phenotyping (NGP) tools that assist clinicians with recognizing characteristic syndromic patterns are particularly challenged when confronted with patients from populations different from their training data. To that end, we systematically analyzed the impact of genetic ancestry on facial dysmorphism. For that purpose, we established the GestaltMatcher Database (GMDB) as a reference dataset for medical images of patients with rare genetic disorders from around the world. We collected 10,980 frontal facial images - more than a quarter previously unpublished - from 8,346 patients, representing 581 rare disorders. Although the predominant ancestry is still European (67%), data from underrepresented populations have been increased considerably via global collaborations (19% Asian and 7% African). This includes previously unpublished reports for more than 40% of the African patients. The NGP analysis on this diverse dataset revealed characteristic performance differences depending on the composition of training and test sets corresponding to genetic relatedness. For clinical use of NGP, incorporating non-European patients resulted in a profound enhancement of GestaltMatcher performance. The top-5 accuracy rate increased by +11.29%. Importantly, this improvement in delineating the correct disorder from a facial portrait was achieved without decreasing the performance on European patients. By design, GMDB complies with the FAIR principles by rendering the curated medical data findable, accessible, interoperable, and reusable. This means GMDB can also serve as data for training and benchmarking. In summary, our study on facial dysmorphism on a global sample revealed a considerable cross ancestral phenotypic variability confounding NGP that should be counteracted by international efforts for increasing data diversity. GMDB will serve as a vital reference database for clinicians and a transparent training set for advancing NGP technology.

Connecting the challenges of quality and equality in higher education using the collective intelligence approach: findings from an international expert panel

This article presents the results of phase one of the B-CAUSE project, an international project designed to connect equity and quality in higher education. Expert stakeholders worked together using collective intelligence methods to develop a shared understanding of (1) key features of equity-focused quality higher education, (2) barriers to equity-focused quality higher education and (3) options for overcoming these barriers. Results highlight the potential transformative dimension to equity-focused, quality higher education, including responsiveness to students, participatory design, pluralism and openness and the educational imperative to promote equity in practice. The barriers and options generated by experts focused on institutional resources and supports, excellence-equity tensions, systemic norms and pressures, reflective complexity, awareness and empathy and student supports. The collective intelligence of experts provides the basis for ongoing research, strategy and pedagogical or curricular innovation as part of the B-CAUSE project and other international efforts to foster equity-focused, quality higher education.

The Palestinian Diaspora: Status and Rights in Middle East and North African Countries

The Palestinian diaspora, beginning with a mass exodus following the establishment of Israel in 1948, has faced diverse and evolving challenges in Middle Eastern and North African host countries. This paper explores the historical and contemporary status of Palestinian refugees in these regions, examining the legal, social, and economic conditions they endure. While neighboring Arab states initially supported Palestinian refugees, their experiences have since been defined by prolonged refugee status and fluctuating levels of hostility. In Lebanon, Jordan, Syria, Egypt, and the Gulf countries, policies have fluctuated based on geopolitical interests and local dynamics. North African countries, while offering some support, also reflect the complexities of Palestinian integration. The ongoing refugee crisis underscores the need for international efforts to address the root causes and ensure the rights and welfare of Palestinian refugees.

Ringing mountain ranges: Teleseismic signature of the interaction of high-frequency wavefields with near-source topography at the Degelen nuclear test site

Summary Over the last decade there has been an international effort to find methods to recover and digitize recordings from historical earthquakes and explosions that occurred during the 1950’s through to the 1980’s. Making these recordings accessible in digital format offers opportunities to study what signatures are encoded in the data, and to apply state-of-the-art techniques and methods to historical data. In this study we employ unsupervised machine learning to cluster historical teleseismic waveforms from nuclear explosions conducted at the former USSR Degelen test site, in Kazakhstan, recorded at seismic arrays in the UK (EKA), Canada (YKA), Australia (WRA) and India (GBA). In particular, we use two unsupervised algorithms to cluster waveforms using shape-based clustering: kernel k-means and k-Shape. The algorithms clearly split waveforms into distinct clusters that are spatially related, even when waveform differences are subtle, and we show with local and teleseismic numerical simulations that the clusters are related to the topography. The topography at the Degelen test site has characteristic wavelengths of 2-4 km and local simulations highlight that the seismic wavefield is trapped in reverberating mountain peaks. The location of the explosion is crucial in determining which section of the mountain range reverberates, influencing the outgoing wavefield. Teleseismic waveform simulations confirm that it is this superposition of energy leaving the reverberating peaks that results in the observed teleseismic waveform differences we observe.

Auditory time travel: Acoustic notes on the virtual reality reconstruction of the Queen's theatre (Adelaide, 1841)

This paper presents the results of an international interdisciplinary effort to reconstruct the Queen's Theatre in Adelaide as it stood on its inaugural debut in 1841. Our collaborative approach brings together real actors, set and costume designers, architects, virtual reality (VR) developers, motion capture specialists, and acoustic engineers in order to reproduce, as realistically as possible, the opening night monologue by Mr Gustavus Arabin. By combining the modelled ambisonics room impulse responses with a proprietary algorithm, we achieved an authentic representation of the historical environment both visually and acoustically by allowing the user to immerse themselves in the space at several locations within the theatre. Central to our VR reconstruction is the ability of our software to combine auralisations from multiple sound sources simultaneously as well as allowing the user to upload user-generated anechoic files. The paper focuses on the acoustic nuances throughout the VR reconstruction, providing a comprehensive overview of collaborative endeavours and technological advancements enabling users to grasp and appreciate the acoustic intricacies of Queen's Theatre. Emphasising the acoustic dimension of the space underscores the potential of our virtual model to serve as a dynamic platform for historical exploration, research, and educational pursuits.

The measurement of tire-road noise: how does standardization contribute to the development of low noise pavements in Europe

Low-noise road pavements are among the most effective solutions for reducing road traffic noise emission at the source. There was a significant international effort over the past years for developing and standardizing methods for measuring tire-road noise emission, essentially Statistical Pass-By (SPB) and Close ProXimity (CPX) methods. The dedicated Working Group of the European Committee for Standardization (CEN/TC227/WG5) recently investigated how these standards are used in practice and how they contribute to the implementation of low-noise pavements. For this, a survey was launched and 14 European countries responded on their practices. The survey showed a large diversity of use, although all refer to the measurement methods SPB, CPX. Based on these methods, some countries have developed national regulations or reference guidelines to specify and assess the acoustic performance of road surfaces. These procedures are, however, significantly different and lead to varying definitions of low-noise pavements, which prevents sharing knowledge, experience and data. This context justifies the ongoing development within CEN/TC227/WG5 of a standard procedure for the acoustic characterization of road pavements based on existing measurement methods. The paper will present and analyze the results of the survey, then will present the ongoing work in CEN.

Governing Silicon Valley and Shenzhen: Assessing a New Era of Artificial Intelligence Governance in the United States and China

This article examines recent developments in artificial intelligence (AI) governance in the United States (US) and China, exploring their implications for each country’s development trajectory. Drawing on a framework informed by the philosophy of technology, the article delves into not only the differences between the two countries’ approaches but also the reasons behind these differences. The US, after years of industry self-regulation, is slowly moving towards concrete legislation, while China is centralizing its development and regulatory initiatives. Despite China’s expressed desire for values-pluralistic international governance, existing tensions between the two, coupled with the US’s burgeoning coalition centered around AI with “democratic values,” might pose challenges to collaboration and international governance. Nonetheless, the article contends that both systems can be accommodated within a values-pluralistic human rights framework, potentially paving the way for meaningful international governance efforts.

Advancing Sustainable Higher Education: Embracing the Triple Bottom Line Integration in Uganda

The purpose of this conceptual paper was to revise Triple Bottom Line Theory of sustainable development as proposed by John Elkington, so as to propose ways of advancing sustainable higher education in Uganda. The major tenets of this theory are economic viability, environmental sustainability and social responsibility. Reduced fiscal spending by governments to higher education, the global calls for mitigation of climate change, youth unemployment and equity calls for higher education to be sustainable, including in Uganda. This paper concludes by proposing that sustainable higher education in Uganda is as a result of : Economic viability (job creation, skill development, research & innovation, community engagement, global education- partnerships with international institutions), environmental sustainability (integration of sustainability in curricula, use of experiential learning, collaboration with stakeholders, addressing resource limitations, empowerment and economic benefits) and social responsibility (community engagement, addressing local and global challenges, integrating social responsibility into missions, and merging social responsibility with internationalization efforts). The paper concludes by recommending empirical validation of the model, both in Uganda and outside Uganda

Prosumer networks – A key enabler of control over renewable energy resources

The global challenges of recent years have exacerbated the energy crisis and highlighted the need for reactive and resilient energy systems. This paper emphasises the role of collaborative networks of prosumers in exploiting renewable energy sources to achieve sovereignty over critical resources. A bibliometric study reveals significant discrepancies between countries in statutory energy policies for renewable energy integration and incentives to prosumerism. A dataset of 27 Romanian individual prosumers illustrates the differences in load profiles between residential and industrial prosumers in a temperate continental climate, highlighting the benefits and limits of increasing the share of renewable energy in the national energy system. The study shows the advantage of aggregators balancing production and consumption, provided enough storage capability is available. It also illustrates the evolution of Romanian prosumers, discussing key regulatory and technological factors, advantages, and barriers to collaboration. This research offers municipalities, public authorities, and infrastructure operators a path towards energy independence, in alignment with international efforts toward the adoption of renewable energy. The study provides valuable insights into the benefits and challenges of renewable energy integration, offering practical solutions for achieving energy independence. It also offers relevant information in the effort of legislative harmonization to enable efficient and secure integration of new actors in the electricity system, encouraging responsible prosumers and aggregators and discouraging opportunistic aggregation

What is known about suicide prevention gatekeeper training and directions for future research.

Suicide prevention training that teaches skills to support a person experiencing thoughts of suicide and create community support networks, often termed, "gatekeeper" training (GKT), has been a longstanding pillar of international, national, and local suicide prevention efforts. GKT aims to improve knowledge, attitudes, and self-efficacy in identifying individuals at risk for suicide, hopefully enhancing one's willingness and ability to intervene with a person experiencing a crisis. However, little is known about GKT's effectiveness in creating the essential behavior change (e.g., increase in intervening behaviors) it sets out to accomplish. This paper explores the history and theoretical background of GKT, reviews the current state of research on GKT, and provides framing and recommendations for next steps to advance research and practice around GKT. Through positioning GKT appropriately within the field of suicide prevention, we argue that the field of suicide prevention needs more rigorous research around GKT that includes long-term follow-up data on usage of skills learned during training, data on outcomes of those who have received an intervention from a trained gatekeeper, and the integration of implementation science to further our understanding of which trainings are appropriate for which helpers.

Should I Stay or Should I go? Resilience, Intention to Quit and Job Satisfaction among Nurses in Intensive Care Units

Addressing the global nursing shortage is crucial to both national and international public health efforts. This paper aims to highlight the importance of resilience and its impact on primary care nurses' job satisfaction and intentions to quit, especially in the face of current challenges. The study utilized a mixed methods design involving nurses in intensive care units of a university hospital in Austria. In the first phase of data collection, qualitative focus group interviews were conducted to gather insights on the current challenges and stressors faced by nursing professionals. Building on relevant literature, a quantitative survey was then administered to all nurses, using scales measuring resilience, intention to quit, and job satisfaction in order to examine the relationships between these variables. In addition, a data structuring of the resilience scale by factors was achieved with the help of confirmatory factor analysis. Subsequently, the correlations of the resilience factors with the other variables were examined by means of an additional correlation, regression and mediation analysis. The results showed negative correlations with regard to resilience and intention to quit as well as with regard to job satisfaction and intention to quit. In contrast, job satisfaction and resilience correlated significantly positively with each other. The negative correlation between resilience and the intention to quit was confirmed, but only for the factors "goal focus" and "pride and commitment". A closer examination of the two factors and their associated items revealed a connection to both professional identity and organizational identity. This study provides valuable insights for health care leaders and health care decision makers to effectively lead, develop, and thereby retain primary care nurses. The authors argue that improving resilience and strengthening organizational identity are important influencing factors in increasing job satisfaction and reducing nurses' intention to quit.

Nanomaterials in asphalt cement: exploring their single and combined effects on the physical and rheological properties

Pavement deterioration due to rutting, fatigue, and thermal cracking poses significant challenges to road infrastructure. Traditional asphalt modifiers often fall short in addressing these issues, leading to growing interest in advanced materials such as nanomaterials. This study investigates the individual and combined effects of three nanomaterials: nano-titanium dioxide (NT), nano-alumina (NA), and nano-silica (NS), on the physical and rheological properties of asphalt binders when used in dosages of 0%, 1%, and 2% by the weight of asphalt. This study aims to enhance asphalt performance and contribute to international research efforts focused on pavement durability. The experimental program evaluated the penetration, softening point, mass loss after aging, and viscosity properties, in addition to rutting and fatigue resistance through dynamic shear rheometer (DSR) tests. Scanning electron microscopy (SEM) was also employed to observe morphological changes. Results showed that 2% NA reduced penetration by 3.19%, while 2% NS increased the softening point by 2.41%. The combination of NA and NS had the highest effect on the softening point (F = 6.21, p = 0.008). NA and NT reduced mass loss, with 2% NA lowering it from 0.432% to 0.201%. Viscosity increased by 17.4% with 2% NA, while the NA and NS combination had the most significant overall impact (F = 44.78, p = 0.000). At higher temperatures, 2% NA was the most effective in reducing aging. Optimizing the use of NA and NS, either individually or combined, offers the best improvements in binder stiffness, thermal stability, and aging resistance.

Promoting Equity, Diversity, and Inclusion in Healthcare: An Example of the COVID-19 Pandemic

Healthcare systems must embody equity, diversity, and inclusion (EDI) and, in the event of unfairness, appropriate policies / countermeasures should be enacted. The healthcare system response to the COVID-19 pandemic not only highlighted how socioeconomic disparities affect mortality risk but also posed significant challenges to the successful practice of EDI in healthcare. In light of this, this article was written to provide an overview of EDI, analyze the international efforts to promote it, and suggest strategies for promoting EDI in infectious disease healthcare using COVID-19 as an example. In healthcare settings, equity centers on ensuring patients receive fair treatment regardless of race, gender, age, or socioeconomic status; diversity centers on healthcare providers understanding the uniqueness of patients from different cultural backgrounds and the health barriers they face; and inclusion centers on ensuring patients are treated with respect and given the attention they deserve. During pandemics, social determinants of health (SDOH) greatly impact patient health outcomes and hinder the practice of EDI. Reflecting on the impact of COVID-19, healthcare systems can actively apply EDI in clinical practice to provide to all patients equitable access to healthcare opportunities and outcomes. Practical strategies include establishing EDI committees within healthcare systems, monitoring relevant data, conducting staff training, and continuously addressing the SDOH and needs of marginalized groups to achieve EDI in healthcare.

Emerging signals of climate change from the equator to the poles: new insights into a warming world

The reality of human-induced climate change is unequivocal and exerts an ever-increasing global impact. Access to the latest scientific information on current climate change and projection of future trends is important for planning adaptation measures and for informing international efforts to reduce emissions of greenhouse gases (GHGs). Identification of hazards and risks may be used to assess vulnerability, determine limits to adaptation, and enhance resilience to climate change. This article highlights how recent research programs are continuing to elucidate current processes and advance projections across major climate systems and identifies remaining knowledge gaps. Key findings include projected future increases in monsoon rainfall, resulting from a changing balance between the rainfall-reducing effect of aerosols and rainfall-increasing GHGs; a strengthening of the storm track in the North Atlantic; an increase in the fraction of precipitation that falls as rain at both poles; an increase in the frequency and severity of El Niño Southern Oscillation (ENSO) events, along with changes in ENSO teleconnections to North America and Europe; and an increase in the frequency of hazardous hot-humid extremes. These changes have the potential to increase risks to both human and natural systems. Nevertheless, these risks may be reduced via urgent, science-led adaptation and resilience measures and by reductions in GHGs.

Effect of Transfer Pricing on Corporation Tax Compliance Among Multinational Corporations in Nairobi Kenya

Purpose: Tax is a compulsory contribution that is made by the citizens of a country to the government for the provision of public utilities. It is evident from the National Tax Policy, 2024 that the Kenya Revenue Authority (KRA) and the government at large have recently shown a lot of interest in multinationals due to the complexity of their operations and the tendency for them to come up with complex tax avoidance mechanisms. This has also been complicated by the widespread abuse of transfer pricing models adopted when dealing with multinational corporations operating in Kenya. This study looked into effect of transfer pricing on corporate tax compliance among multinational corporation companies in Kenya. The study was guided by the following theories, AS theory, the Slippery Slope Framework, and the theory of the planned behavior. Methodology: The study employed an explanatory research design. The target population was 221 multinational corporations’ companies and a sample size of 142 respondents. Questionnaires were used to collect primary data and analysis was descriptive statistics include frequency, percentage, and mean while inferential statistics included correlation and multiple regression. Results: The study findings found out most companies in Nairobi, Kenya have transfer pricing policies that are moderately but not adequately in line with domestic tax statutes. Most companies will use transfer pricing as a tool to reduce their tax liabilities. Further, KRA is moderately but not adequately efficient in monitoring and regulating transfer pricing practices in our company. Conclusion: The study results concluded that transfer pricing affects corporation tax compliance Based on the findings, the study recommends there is a need for exchange of information and more international collaborative efforts from a policy, legal, and academic front to address aggressive tax avoidance practices from MNCs. Therefore, future studies can be conducted on the impact of Dispute resolution mechanism on corporation tax performance.

Surgical Care in Refugee Populations: Addressing the Unmet Needs and Overcoming Challenges

The global refugee population, currently estimated at 35.3 million by the United Nations High Commissioner for Refugees (UNHCR), is one of the most vulnerable groups in the world, facing daily threats of violence, conflict, and persecution. While international efforts to address these crises are ongoing, the increasing number of displaced individuals underscores the urgent need for sustainable solutions. Among the myriad challenges refugees face, access to adequate healthcare remains a critical concern, particularly in the domain of surgical care.

Patterns and Pathways: Teachers’ Perceptions, Readiness, Support, and Barriers to Internationalization in Higher Education

In higher education, internationalization is essential because it exposes students to a globalized environment; however, teachers must be sufficiently prepared for this challenge to internationalize. Many studies emphasize the significance of faculty views on and institutional support in relation to institutionalization; however, there is a knowledge gap regarding how perceptions, support, and barriers interact with teachers’ readiness for and obstacles to internationalization, particularly in the Philippine setting. To fill this gap, this descriptive-correlational study used random sampling to examine 200 higher education teachers’ views on and readiness for institutionalization, the institutional support available, and barriers to institutionalization at state universities and colleges in Central Visayas, Philippines. Online surveys were used to collect data, which were then subjected to regression and descriptive analysis. Findings reveal that teachers have positive perceptions, receive ample support, and encounter barriers to internationalization. Based on their attitudes, beliefs, and pedagogical strategies, they were ready to engage in internationalization activities, they were well prepared in terms of professional development, cultural competence, and language proficiency, but only moderately ready to engage in internationalization, because of limited prior experience. Their institutions supported them through dedicated offices responsible for coordinating international efforts; however, they were also challenged by their institutions’ lack of financial resources and limited access to global networks and partnerships. According to the study findings, improving teachers’ preparedness necessitates building institutional support, promoting positive attitudes, and systematically removing obstacles. It is advised that institutional policies are strengthened. Research is required to fully understand these dynamics in various educational situations.

COMBATING ISLAMOPHOBIA AFTER THE AL-AQSA FLOOD

The present study aims to examine the increasingly widespread phenomenon of Islamophobia linked to the Al-Aqsa Flood in 2023. National practices worldwide convincingly demonstrate that Islamophobia has increased since Israel launched its war on the Gaza Strip, breaking international laws egregiously and depriving Palestinians of their rights. In addition to this, cases of hate crimes directed at Muslims have now hit peak levels. Therefore, the current study aims to discuss the origin, motivation, and consequences of Islamophobia, probing international efforts to stop it and analytically examining the impact of the war in Gaza on the worldwide diffusion process of Islamophobia. In other words, a critical reading of Islamophobia is presented in line with a descriptive-analytical and historical approach, asserting that incidents of attack, hatred, and incitement against Muslims related to Islamophobia have risen abruptly since the start of Israel’s war on Gaza, heating the anti-Muslim sentiment and raising transnational Islamophobia. Ultimately, the study found that effectively combating Islamophobia associated with the recent war in Gaza requires taking all necessary steps to end the war and shielding Palestinian people from Israeli strikes. Accordingly, the study recommends suggestions for effective strategies to deal with, counter, and lessen Islamophobia’s negative consequences in a manner that complies with international law standards.

The net zero wave: identifying patterns in the uptake and robustness of national and corporate net zero targets 2015–2023

ABSTRACT Since the 2015 Paris Agreement, a growing number of states and firms have adopted targets to reach net zero emissions. These pledges vary significantly both in the timing of adoption and in robustness – measured by whether they adopt procedural best practices. We introduce a novel time-series dataset measuring the uptake and robustness of net zero targets of states and the world’s largest listed firms between 2015 and 2023. The new data allow us to identify patterns that speak to a key debate in the literature: what explains the rapid uptake of net zero targets by firms and countries? Descriptive inference yields several insights. First, the timing of net zero adoption by both states and firms strongly tracks international mobilization efforts, highlighting the importance of the United Nations (UN) process for target setting. Second, on average, firms set targets before countries. Third, there is an increase in some best practices for companies, such as setting interim targets and including Scope three emissions in targets, alongside a lack of progress in others, such as safeguards on the use of offsetting. Importantly, we do not find significant variation in timing or robustness of net zero pledges across firms in different sectors. For countries, early adopters tend to have more robust targets from the beginning than late adopters, suggesting the latter may be adopting more symbolic targets. In sum, our results show the rapid growth of the net zero wave, but also its limits in driving robust targets.