Sanitation, water supply and their governance remain major challenges in many Pacific Island Countries. National sustainable development strategies (NSDSs) are promoted throughout the Pacific as overarching improved governance instruments to identify priorities, plan solutions and fulfill commitments to sustainable development. Their relevance to local village-level development priorities is uncertain. The Kingdom of Tonga provides opportunities to compare both. Tonga’s Strategic Development Frameworks (TSDFI 2011-2014 and TSDFII 2015-2025) were developed to focus government and its agencies on national outcomes. From 2007 to 2016, 136 villages throughout Tonga’s five Island Divisions (IDs) formulated Community Development Plans (CDPs) involving separately 80% of women, youth and men in each village. Censuses in 2006 and 2016 show linked improvements in water supply and sanitation systems but reveal IDs with continuing challenges. Sanitation and water are prominent in TSDFI but absent from the current TSDFII. In contrast, CDPs show in one ID, 53% of villages ranked sanitation as a priority with marked differences between IDs and between women, youth and men. CDPs’ sanitation priorities in IDs mostly correspond to sanitation and water metrics in the Censuses, but some reflect impacts of natural disasters. Explanations for differences in sanitation priorities between national and local development plans, as well as suggestions for improving NSDS processes in island countries, are advanced.

Historically, macrophages have been long implicated in the control of the severity of infectious diseases. This has been based on the observations of a higher risk of severe disease and death upon rechallenge with viral variants due to antibody dependent enhance-ment (ADE) of infection into macrophages. The question remains as to what can account for this potent heterologous protection in macrophages? Here it is argued that the elusive defense mechanism of M1-like pro-inflammatory macrophages may pertain to a novel virus anti-virus response. This system initiates with high replication of human endogenous retrovirus K102 (HERV-K102), a non-pathogenic, protector foamy retrovirus of humans which generates M1-like pro-inflammatory foamy macrophages, glycolysis, and epigenetic changes, all characteristic of trained immunity. This virus-anti-virus system kills virally infected cells by several mechanisms, amplifies the innate interferon response via ‘viral mimicry’, has many unique components that interfere with exoge-nous virus replication, and may be especially adept at neutralizing enveloped exogenous pandemic viruses, such as SARS-CoV-2 and HIV-1. The goal of this treatise is to introduce the multifaceted HERV-K102 protector system, to illustrate how SARS-CoV-2 may target the HERV-K102 protector system by ADE, and to explore how this innate defense system may be exploited for pandemic preparedness.

Background: Cervical cancer prevention in regions with limited access to screening and HPV vaccination necessitates innovative approaches. This study explored the potential of a test-and-treat strategy using mRNA HPV tests to impact cervical cancer prevention in a high-prevalence HIV population. Methods: A cervical screening study was conducted at three South African hospitals involving 710 under-screened, non-pregnant women (25 to 65 years) without known cervical diseases. Cytology, HPV testing, colposcopy, and biopsies were performed concurrently. Histopathologists determined final histological diagnoses based on biopsy and LLETZ histology. mRNA-HPV-genotyping for 3 (16, 18, 45) to 8 (16, 18, 31, 33, 35, 45, 52, 58) high-risk types was performed on leftover liquid-based cytology material. The preventive potential of the test-and-treat approach was estimated based on published data, reporting the causative HPV types in cervical cancer tissue from South African women. Treatment was provided as needed. Results: HPV positivity rate more than doubled from 3-type (15.2%; 95% CI: 12.6-17.8) to 8-type mRNA (31.5%; 95% CI: 28.8-34.9) combinations, significantly higher among HIV-positive women. CIN3+ prevalence among HIV-positive women (26.4%) was double that of HIV-negative women (12.9%) (p<0.01). The 6-type combination showed the best balance of sensitivity, specificity and treatment group size, and effectiveness to prevent cervical cancer. A 4-type combination (16, 18, 35, 45) could potentially prevent 77.6% (95% CI: 71.2-84.0) of cervical cancer burden by treating 20% and detecting 41.1% of CIN3 cases in the study group. Similarly, a 6-type combination (16, 18, 31, 33, 35, 45), treating 25% and including 62% of CIN3 cases, might prevent 85% of cervical cancer cases (95% CI: 79.6-90.6) among HIV-positive and negative women. Conclusion: Employing mRNA HPV tests within a test-and-treat approach holds huge promise for targeted cervical cancer prevention in under-screened populations. Testing for mRNA of the 6 highest-risk HPV types in this population and treating them all is projected to effectively prevent progression from CIN3 to invasive cervical cancer while reducing overtreatment in resource-constrained settings.

In order to counter the impending shortage of skilled professionals in the aging societies of our time in many western countries such as Germany, solutions for business and society are urgently needed. Here, artificial intelligence (AI) can play an important role in mitigating the problem with the help of diverse applications. At the same time, it is important to consider both the needs of the respective employee1 and the company to ensure that the use of AI has a positive impact on the organization and finds social acceptance. In this article, we describe the newly developed OSQE model (Optimize, Secure, Qualify, Expand), which for the first time outlines an AI cycle against the shortage of skilled professionals in a holistic approach that focuses equally on people and companies. This can serve organizations as a guide for strategy development, decision-making for and implementation of AI-supported measures in an entire cycle of an employee's affiliation with a company. The model takes three driving forces into account: companies, professionals, and AI applications. In the model, the measures to be implemented are prioritized with ascending numbering based on what would be most urgent for a company to implement. All measures relate to areas of action that place people at the center and can be assigned to the classic cycle of belonging of an employee in the company. In this regard, the opportunities that AI offers to professionals and companies are highlighted.

Background: This study examines the relationship between energy usage, health issues, and pro-environmental behavior (PEB) in Kyrgyzstan, amidst the country's commitment to transition from coal-based energy to renewable sources in line with the Paris Agreement. The purpose is to investigate citizens' attitudes towards PEB and their intentions to engage in environmentally friendly actions, focusing on gas, electricity, and coal. Methods: Drawing upon the Theory of Planned Behavior (TPB) framework, a survey was conducted among 1,455 respondents to explore attitudes towards PEB and energy sources' impact on health issues. Results: Decarbonization efforts in Kyrgyzstan and Central Asia are in their early stages, with coal remaining a primary energy source. The study emphasizes the importance of governmental policies and citizen action in achieving decarbonization goals. Rising electricity costs outweigh the increase in indirect energy costs for food, posing challenges for households in adapting to changing energy dynamics. Conclusions: Targeted interventions and communication strategies are crucial to promote pro-environmental behavior and facilitate the transition to sustainable energy sources. Understanding the relationships between health concerns, air pollution awareness, PEB, and energy source choices can inform policymakers and organizations in their efforts to ensure a sustainable and healthy future for Kyrgyzstan and other Central Asian countries.