BackgroundThe introduction of a systematic framework for the licensing of health care professions, which is a crucial step in ensuring the quality of human resources for health (HRH), is still evolving in Lao People’s Democraic Republic. The aim of this study was to review and document the evolution of Lao HRH policies and the development of its national licensing system.Case presentationA qualitative descriptive case study methodology was applied to document and describe how Lao People’s Democratic Republic laid the foundation for the development of a licensing system.The results demonstrate that Lao People’s Democratic Republic is currently in the process of transitioning the focus of its HRH policies from the quantity and deployment of services to remote areas to improvements in the quality of services. The key events in the process of developing the licensing system are as follows: (1) the systematic development of relevant policies and legislation, (2) the establishment of responsible organizations and the assignment of responsible leaders, (3) the acceleration of development efforts in response to the Association of Southeast Asian Nations Mutual Recognition Arrangement for standard qualifications, (4) the strengthening of educational systems for fostering competent health care professionals, (5) the introduction of a 3-year compulsory service component in rural areas for newly recruited government servants, and (6) the introduction of a requirement to obtain a professional health care certificate to work in a private hospital. The Lao Ministry of Health (MOH) has endorsed a specific strategy for licensing to realize this system.ConclusionThe need for licensing systems has increased in recent years due to regional economic integration and a shift in policy toward achieving universal health coverage. A national licensing system would be a significant milestone in health system development, helping to ensure the competency of health care professionals by means of a national examination, continuing professional development, and the revoking of licenses when appropriate.

Nivolumab has promising efficacy for treating various advanced malignant tumors, although it has been reported to induce a wide range of autoimmune adverse effects. We herein report the case of a patient with metastatic lung adenocarcinoma who developed adrenal insufficiency after 12 cycles of nivolumab treatment. Endocrine test results supported a diagnosis of isolated adrenocorticotropic hormone deficiency due to hypophysitis, and replacement therapy using hydrocortisone has been successful. Although hypophysitis is a rare immune-related adverse event that is associated with nivolumab therapy, clinical awareness is essential, as this condition can be life-threatening and requires prompt treatment.

Culling large herbivores can reduce browsing damage. Our objective was to verify the effect of culling by considering spatial changes in browsing damage to test the hypothesis that the benefits of spatially biased culling extend to the spatial scale of culling. Culling sika deer (Cervus nippon) in Kumamoto Prefecture, Japan, increased from 2009–2017, but browsing damage remained stable across the prefecture; regional damage trends differed among grid meshes (i.e., 5 km × 5 km). Meshes with browsing damage reduction received higher culling pressure and a decline in the deer population. Browsing damage reduction from culling was not uniform across regions and was biased by spatial bias in culling. This study highlights the importance of spatial scale in large herbivore management and evaluation of its effect.

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To respond to rapidly growing demands for clinical research at the local level, it is important to build robust research infrastructure in low-and middle-income countries. The 2014-2015 Ebola outbreak in West Africa revealed the lack of infrastructure, expertise, and regulations in the face of an urgent need for clinical trials at the local level during public health crises (1). The number and complexity of clinical trials have increased significantly in recent years. According to ClinicalTrials. gov, a registry of clinical studies conducted worldwide in 220 countries, the number of registered clinical studies is rising from 325,773 in 2019-2020 to 362,505 in 2020-2021 (2). The complexity of clinical trials has also increased, particularly since the novel coronavirus infection (COVID-19) pandemic. Consequently, the demand for clinical research professionals exceeds availability, and global efforts to increase the clinical research workforce are underway (3).International cooperation in clinical research is essential for addressing common global health issues and enabling the provision of evidence-based solutions to patients and health professionals in a timely manner. In the face of the COVID-19 pandemic, the need for global cooperation in clinical research to overcome unprecedented health challenges has been reaffirmed. However, multinational research is complex due to differences in regulatory and ethical requirements, medical systems, health priorities, and cultures between countries. These barriers affect the scope of research (247)