Introduction. Rational use of antibacterial agents is a key component of strategies aimed at containing antimicrobial resistance. The World Health Organization (WHO) AWaRe (Access, Watch, Reserve) classification, combined with the ATC/DDD methodology, provides a standardized approach for assessing both the volume and structure of antibiotic consumption and identifying priorities for antimicrobial stewardship. Objective. To analyze the structure and trends of systemic antibiotic consumption in a multidisciplinary hospital in Astana during 2022–2024 using the WHO ATC/DDD methodology and the WHO AWaRe classification, and to interpret the observed changes in the context of changes in the hospital's clinical profile. Materials and Methods. A retrospective observational study was conducted using aggregated, de-identified data from the hospital's internal pharmacoepidemiological reporting system for 2022–2024. Consumption of systemic antibacterials classified under ATC group J01 was assessed according to the WHO ATC/DDD methodology and expressed as DDD per 100 bed-days. Antibiotics were categorized according to the WHO AWaRe classification. The five most frequently consumed international nonproprietary names and the seven leading ATC groups were additionally analyzed. Results were reported as absolute values and relative proportions without inferential statistical testing. Results. Total systemic antibiotic consumption was 62.74 DDD/100 bed-days in 2022, 64.50 in 2023, and 52.33 in 2024. Watch antibiotics predominated throughout the study period, accounting for 62.67%, 63.89%, and 85.75% of total consumption, respectively. The proportion of Access antibiotics declined from 37.22% in 2022 to 36.02% in 2023 and 14.20% in 2024, whereas Reserve antibiotics remained below 0.2%. Ceftriaxone was the most frequently consumed antibiotic throughout the study period, increasing from 23.33 to 44.86 DDD/100 bed-days. At the ATC-group level, J01D consistently predominated, with consumption increasing from 25.76 to 47.58 DDD/100 bed-days. Discussion. The persistently high proportion of Watch antibiotics and the decline in Access antibiotics to levels substantially below the WHO target of ≥60% highlight the need to strengthen antimicrobial stewardship and routine consumption monitoring. However, the pronounced shift observed in 2024 should be interpreted in the context of changes in the hospital structure, including the introduction of cardiovascular surgery, vascular surgery, and intensive care units, where the need for broader-spectrum antibacterial therapy may be greater. Thus, the observed consumption pattern likely reflects both prescribing practices and changes in the clinical case mix of the hospital. Conclusion. Combined use of the WHO AWaRe classification and ATC/DDD methodology identified a persistent predominance of Watch antibiotics and an insufficient proportion of Access agents. Routine AWaRe-based monitoring adjusted for the clinical profile of hospital departments may support antimicrobial stewardship and optimization of antibacterial therapy in multidisciplinary hospitals. Keywords: systemic antibiotics; WHO AWaRe; ATC/DDD; DDD per 100 bed-days; antimicrobial resistance; antimicrobial stewardship; ceftriaxone; multidisciplinary hospital; pharmacoepidemiology.
The Middle Upper Paleolithic of the southern Caucasus and Armenian Highlands ( 32–24 ka) is distinct from other similarly aged assemblages in adjacent regions. Therefore, this region provides a primary opportunity to explore patterns of variability in Homo sapiens technological and behavioral adaptations during the Late Pleistocene. Here, we present data on the organization of technology at the open-air site of Solak-1, located in central Armenia along the Hrazdan River and dated to 27 ka. We present a broad range of analyses regarding core curation and reduction intensity, blank production, toolkit composition, and raw material procurement to assess site use and mobility patterns of the Solak-1 toolmakers. These results support the interpretation of Solak-1 as a short-term logistical camp primarily used for the retooling of small lithic armatures. We then compare these results with other Upper Paleolithic sites in the Armenian Highlands, highlighting the flexible nature of these bladelet technologies across time and space and the differences in such behaviors compared to the preceding Middle Paleolithic. Our results broaden our understanding of H. sapiens behavioral variability during the Middle Upper Paleolithic across both open-air and cave contexts within the ecologically diverse landscapes of the Armenian Highlands.
Abstract Despite widespread recognition of the shrub encroachment threat to grassland globally, a clear understanding of its region-specific effects on plant community diversity in Central Asian steppes remains lacking. Accordingly, field investigations in the Suusamyr Valley of Kyrgyzstan were conducted to examine the effects of Caragana aurantiaca encroachment gradients (no, light and severe encroachment) on alpine steppe herbaceous communities across different slopes. Our results revealed that 47 herbaceous species were monitored, and shrub encroachment did not alter the dominance of Festuca valesiaca and Stipa capillata in the community, but led to an increase in shade-tolerant and poisonous species. The effects of shrub encroachment on herbaceous community characteristics were modulated by slope aspect and position. Specifically, herbaceous height, cover, and aboveground biomass (AGB) varied primarily with slope position, whereas diversity was largely determined by slope aspect. On upper slope positions, severe shrub encroachment significantly increased herbaceous height (33.34%) but decreased both vegetation cover (5.74%) and AGB (17.70%). Conversely, herbaceous cover significantly increased by 22.57% on lower slope positions, while height showed no significant change under severe encroachment. Plant diversity was enhanced by shrub encroachment on lower slopes across aspects, but was significantly reduced on upper slopes. Furthermore, severe shrub encroachment significantly decreased the Shannon-Wiener index, Species richness, and herbaceous cover compared to light shrub encroachment. Overall, our study deepens the understanding of how shrub encroachment influences Central Asian grassland ecosystems, offering essential insights for developing science-based restoration and management frameworks in alpine steppe ecosystems.
Traditionally, reliable obsidian sourcing requires expensive calibration standards and extensive geological reference collections as well as experience with statistical processing. In the South Caucasus — one of the most obsidian-rich regions on the planet — this combination of requirements has often restricted sourcing studies because few projects have geological reference collections that cover all known obsidian sources. To test an alternative approach, we conducted “open sourcing” using portable X-ray fluorescence (pXRF) analyses of geological specimens with three key changes to the conventional method: (1) commercially available calibration standards were replaced with a loanable Peabody-Yale Reference Obsidians (PYRO) set, (2) a comprehensive geological reference collection was replaced with a published dataset of consensus values (Frahm, 2023a, 2023b), and (3) processing in statistical packages was replaced with two semiautomated machine-learning workflows available online. For comparison, we used classification by-eye with JMP 17.2 statistical software. Furthermore, we propose a new method to evaluate calibrations, which streamlines comparisons and which we refer to as a symmetric difference ratio (SDR). The results of this feasibility study demonstrate that this “open sourcing” workflow is reliable, yet currently only in combination with classification by-eye. When the consensus values were combined with the machine-learning solutions, the classification results were unsatisfactory. The most encouraging aspect of our alternative “open sourcing” workflow is that it enables correct source identification without physically measuring reference collections, therefore surmounting an obstacle that, until now, has severely limited archaeological research. We anticipate that rapid developments in machine-learning will also soon improve the workflow.
This study examines the sovereignty-internationalism paradox in AI governance, which encapsulates the tension between state control over algorithmic systems and the necessity of transnational collaboration to regulate borderless technologies. AI systems simultaneously reinforce national sovereignty while demanding global cooperation, posing a fundamental challenge to governance frameworks. Through a comparative analysis of the European Union’s AI Act and China’s Social Credit System, this research explores how AI governance can either enable state authority or necessitate transnational coordination. The EU’s risk-based regulatory model demonstrates a supranational approach balancing innovation with ethical oversight, while China’s centralized AI-driven governance exemplifies state-centric control through algorithmic surveillance. To address these tensions, the study introduces Digital Federalism, a governance model that integrates subsidiarity and multi-tiered sovereignty, enabling regulatory coordination across local, national, and global levels. Unlike polycentric governance, which emphasizes decentralization, Digital Federalism retains hierarchical coordination while allowing for adaptive, context-sensitive governance. By bridging classical sovereignty theories with contemporary digital governance debates, this paper argues that reconciling national sovereignty and transnational cooperation requires adaptive frameworks prioritizing transparency, inclusivity, and accountability. The findings illuminate the interplay between state power and global governance, providing insights for policymakers navigating AI governance frameworks in an interconnected world.
