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PubMed1994

Developing a new picture archiving and communication system for the new Osaka University Hospital.

Osaka University Hospital moved into a new hospital building on the suburban Suita campus in October 1993. A newly developed hospital information system, a new radiologic information system and phase I of a completely new Picture Archiving and Communication System (PACS) also began operating. Work began in 1986 on this PACS. The PACS effort has been guided by one working group and two committees during the last 7 years. A survey of the previous diagnostic and image delivery system was performed as part of the preamble to designing an optimal PACS. Extensive analysis and measurement of pre-existing operational conditions was undertaken. These studies and technical research projects are described in a companion paper in this issue. The phase I hardware installation and initial testing were completed in March 1994. Subsequent phases will build incrementally until the completely new, hospital-wide PACS is realized.

Computer Systems↗
PubMed2002

Conservation and development projects in the Brazilian Amazon: lessons from the Community Initiative Program in Rondônia.

Community-based conservation and development has become the prevailing programmatic paradigm of conservation organizations and development donors over the last 20 years, spawning a myriad of integrated conservation and development projects (ICDP) around the world. Appealing for its ambitious aspiration to harmonize sustainable economic development at the local level with the conservation of legally established protected areas (e.g., parks and reserves), the ICDP approach recently has drawn criticism from conservation biologists for failing to ensure adequate protection of biodiversity. Development planners and economists have also raised questions about the financial sustainability of ICDPs in practice and the replicability of the model from highly local contexts to larger regional scales. This paper briefly reviews the central elements of the concept of integrated conservation and development and the emerging debate over its effectiveness. A description of the Community Initiative Program (CIP), a pilot program of the Rondônia Natural Resources Management project (PLANAFLORO) in the western Brazilian Amazon state of Rondônia, follows. The CIP is a significant experiment because it boldly attempted to apply the principles of ICDP to the regional scale involving numerous different communities in one program simultaneously. Based on the author's mid-term review of the CIP in 1999, the development and conservation impacts of the program are considered. While the CIP has not significantly curbed the degradation of protected areas in Rondônia as intended, the evidence suggests lower rates of deforestation in municipios (i.e. counties) with the highest concentrations of CIP projects. Although the economic development impacts are mixed, approximately 50% of the projects delivered tangible benefits to local communities. Lessons learned from the CIP are presented in the final section. Among the lessons learned from the CIP, detailed in the final section, are several that will be familiar to other ICDP evaluators: the importance of thematic coherence in initial project design, the need for explicit attention on environmental conservation objectives, deficient institutional capacity of implementing organizations, inadequate attention to women's concerns and roles in community projects, and lack of technical criteria for measuring project sustainability.

Agriculture↗
PubMed2025

Macrolide-resistant Mycoplasma pneumoniae resurgence in Chinese children in 2023: a longitudinal, cross-sectional, genomic epidemiology study.

BACKGROUND: After a prolonged period of low detection rates, Mycoplasma pneumoniae resurged in China, during September to November, 2023, raising global concern. This study aims to gain a better understanding of the genetic mechanisms underlying the 2023 increase in cases and the evolutionary dynamics of the epidemic populations, which has been previously hampered due to limited genomic data of this pathogen. METHODS: We sequenced 685 M pneumoniae isolates, including 248 isolates from 11 Chinese provinces and municipalities in 2023 and 437 isolates from Beijing (2013-22). By analysing these isolates and 436 publicly global sequences, we reconstructed the pathogen's evolutionary history using time-calibrated phylogenies and effective population size inference. We investigated potential genomic variations contributing to the 2023 resurgence through genome-wide association study and conducted phylogeographic analysis of the 2023 isolates across China. FINDINGS: Two macrolide-resistant epidemic clusters (T1-2-EC1 and T2-2-EC2) were responsible for the 2023 resurgence in China. Both clusters, having acquired the 23S ribosomal RNA A2063G mutation conferring macrolide resistance, emerged in approximately 1997 and 2014, respectively, and subsequently outcompeted their predecessor populations. This coincided with China's large-scale adoption of azithromycin for paediatric community-acquired pneumonia around the early 2000s. Aside from macrolide resistance, T1-2-EC1 independently acquired 17 clade-specific mutations and T2-2-EC2 four clade-specific mutations, which could further explain their increased competitiveness. Whole-genome analysis revealed no resurgence-specific mutations in the 2023 isolates. Phylogeographic analysis showed rapid mixing of T1-2-EC1 isolates between different sampled regions within China. INTERPRETATION: Our study provides evidence that the 2023 resurgence in China is a continuation of the pre-COVID epidemic, rather than emergence of novel variants. The high prevalence of macrolide resistance and rapid intranational spread emphasise the urgent need for enhanced global surveillance of this pathogen. FUNDING: National Key Research and Development Program of China, National Natural Science Foundation of China for Key Programs of China Grants, and Beijing High-Level Public Health Technical Talent Project.

Humans↗
PubMed2005

Global parasite control initiative of Japan (Hashimoto Initiative).

The Asian Centre of International Parasite Control (ACIPAC) was established in Bangkok in March 2000 as a JICA technical cooperation project in collaboration with the Mahidol University and the Ministry of Public Health, Thailand. Since then, ACIPAC carried out its activities with emphasis on the establishment of the concept of school health-based parasite control in the Great Mekong sub-region countries. In addition to contributing human resource development through its training courses on school-based malaria and STH control for programme managers and also through small-scale pilot projects implemented in partner countries, ACIPAC proposed that schoolchildren should be considered as health partners rather than simple recipients of health services including deworming programmes.

Adolescent↗