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ANGPTL3, PCSK9, and statin therapy drive remarkable reductions in hyperlipidemia and atherosclerosis in a mouse model [Commentary]




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Is CYP2C70 the key to new mouse models to understand bile acids in humans? [Commentary]




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Problem Notes for SAS®9 - 65852: The PANEL procedure produces incorrect results for certain models when the NOINT and RANONE options are specified

The estimation results might be incorrect in PROC PANEL when the RANONE and NOINT options are specified in the MODEL statement.




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Problem Notes for SAS®9 - 34294: A missing discrete dependent variable in the selection model together with a OUTPUT statement might cause an Access Violation error

If the following conditions are met in PROC QLIM: the SELECT option and DISCRETE option are specified in the same MODEL statement or ENDOGENOUS statement the same dependent variable with S




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Glasnow working to quicken delivery

Tyler Glasnow is hoping to build off a positive 2018, but his delivery is going to look a little different this season.




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Delineating an extracellular redox-sensitive module in T-type Ca2+ channels [Membrane Biology]

T-type (Cav3) Ca2+ channels are important regulators of excitability and rhythmic activity of excitable cells. Among other voltage-gated Ca2+ channels, Cav3 channels are uniquely sensitive to oxidation and zinc. Using recombinant protein expression in HEK293 cells, patch clamp electrophysiology, site-directed mutagenesis, and homology modeling, we report here that modulation of Cav3.2 by redox agents and zinc is mediated by a unique extracellular module containing a high-affinity metal-binding site formed by the extracellular IS1–IS2 and IS3–IS4 loops of domain I and a cluster of extracellular cysteines in the IS1–IS2 loop. Patch clamp recording of recombinant Cav3.2 currents revealed that two cysteine-modifying agents, sodium (2-sulfonatoethyl) methanethiosulfonate (MTSES) and N-ethylmaleimide, as well as a reactive oxygen species–producing neuropeptide, substance P (SP), inhibit Cav3.2 current to similar degrees and that this inhibition is reversed by a reducing agent and a zinc chelator. Pre-application of MTSES prevented further SP-mediated current inhibition. Substitution of the zinc-binding residue His191 in Cav3.2 reduced the channel's sensitivity to MTSES, and introduction of the corresponding histidine into Cav3.1 sensitized it to MTSES. Removal of extracellular cysteines from the IS1–IS2 loop of Cav3.2 reduced its sensitivity to MTSES and SP. We hypothesize that oxidative modification of IS1–IS2 loop cysteines induces allosteric changes in the zinc-binding site of Cav3.2 so that it becomes sensitive to ambient zinc.




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Connecting Rodent and Human Pharmacokinetic Models for the Design and Translation of Glucose-Responsive Insulin

Despite considerable progress, development of glucose-responsive insulins (GRI) still largely depends on empirical knowledge and tedious experimentation – especially on rodents. To assist the rational design and clinical translation of the therapeutic, we present a Pharmacokinetic Algorithm Mapping GRI Efficacies in Rodents and Humans (PAMERAH), built upon our previous human model. PAMERAH constitutes a framework for predicting the therapeutic efficacy of a GRI candidate from its user-specified mechanism of action, kinetics, and dosage, which we show is accurate when checked against data from experiments and literature. Results from simulated glucose clamps also agree quantitatively with recent GRI publications. We demonstrate that the model can be used to explore the vast number of permutations constituting the GRI parameter space, and thereby identify the optimal design ranges that yield desired performance. A design guide aside, PAMERAH more importantly can facilitate GRI’s clinical translation by connecting each candidate’s efficacies in rats, mice, and humans. The resultant mapping helps find GRIs which appear promising in rodents but underperform in humans (i.e. false-positives). Conversely, it also allows for the discovery of optimal human GRI dynamics not captured by experiments on a rodent population (false-negatives). We condense such information onto a translatability grid as a straightforward, visual guide for GRI development.




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Is Type 2 Diabetes Mellitus Causally Associated with Cancer Risk? Evidence From a Two-Sample Mendelian Randomisation Study

We conducted a two-sample Mendelian randomisation study to investigate the causal associations of type 2 diabetes mellitus (T2DM) with risk of overall cancer and 22 site-specific cancers. Summary-level data for cancer were extracted from the Breast Cancer Association Consortium and UK Biobank. Genetic predisposition to T2DM was associated with higher odds of pancreatic, kidney, uterine and cervical cancer, lower odds of oesophageal cancer and melanoma, but not associated with 16 other site-specific cancers or overall cancer. The odds ratios (95% confidence interval) were 1.13 (1.04, 1.22), 1.08 (1.00, 1.17), 1.08 (1.01, 1.15), 1.07 (1.01, 1.15), 0.89 (0.81, 0.98), and 0.93 (0.89, 0.97) for pancreatic, kidney, uterine, cervical, and oesophageal cancer and melanoma, respectively. The association between T2DM and pancreatic cancer was also observed in a meta-analysis of this and a previous Mendelian randomisation study (odds ratio 1.08; 1.02, 1.14; p=0.009). There was limited evidence supporting causal associations between fasting glucose and cancer. Genetically predicted fasting insulin levels were positively associated with cancers of the uterus, kidney, pancreas and lung. The present study found causal detrimental effects of T2DM on several cancers. We suggested to reinforce the cancers screening in T2DM patients to enable the early detection of cancer.




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Erratum. Multiethnic Genome-Wide Association Study of Diabetic Retinopathy Using Liability Threshold Modeling of Duration of Diabetes and Glycemic Control. Diabetes 2019;68:441--456




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The Histone Methyltransferase MLL1 Directs Macrophage-Mediated Inflammation in Wound Healing and Is Altered in a Murine Model of Obesity and Type 2 Diabetes

Andrew S. Kimball
Sep 1, 2017; 66:2459-2471
Immunology and Transplantation




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The High-Fat Diet-Fed Mouse: A Model for Studying Mechanisms and Treatment of Impaired Glucose Tolerance and Type 2 Diabetes

Maria Sörhede Winzell
Dec 1, 2004; 53:S215-S219
Section V: The Incretin Pathway




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Pancreas Pathology of Latent Autoimmune Diabetes in Adults (LADA) in Patients and in a LADA Rat Model Compared With Type 1 Diabetes

Anne Jörns
Apr 1, 2020; 69:624-633
Islet Studies




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Madeleine Forster

Richard and Susan Hayden Academy Fellow, International Law Programme

Biography

Madeleine is the Richard and Susan Hayden Academy Fellow, hosted in the International Law Programme.

Prior to joining Chatham House, she provided specialist legal services to United Nations humanitarian operations in the Middle East. She brings particular expertise in applied international human rights law across complex political, security and operational environments. She has also acted on internal United Nations boards of inquiry and system efforts to combat sexual exploitation and abuse.

Her current research interests are at the intersection of international law, ethics and technology, including the potential and pitfalls of innovative solutions to refugee and migrant crises.

Madeleine began her career as an employment lawyer with global law firm DLA Piper, has been an Australian Youth Ambassador for Development in Cambodia, and holds a Master of Laws from the University of Melbourne, where she was awarded the Edward Walter Outhwaite Prize for academic achievement in human rights.  

Areas of expertise

  • International law
  • Ethics & technology
  • Refugee law and policy
  • Middle East & North Africa region experience
  • Combatting sexual exploitation and harassment in organisations

Past experience

2015-19Legal officer (Protection), United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA)
2015Lawyer, Victorian Department of Education
2014-15Australian Youth Ambassador for Development (Cambodia)
2013DLA Piper Secondee Lawyer, Human Rights Law Centre
2010-13Lawyer, DLA Piper Australia




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Cow’s milk allergy guidelines are not evidence based and are beset by conflicts of interest, researchers warn




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Covid-19: Health needs of sex workers are being sidelined, warn agencies




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Nuclear Tensions Must Not Be Sidelined During Coronavirus

1 May 2020

Ana Alecsandru

Research Assistant, International Security Programme
Although the pandemic means the Nuclear Non-Proliferation Treaty (NPT) Review Conference (RevCon) is postponed, the delay could be an opportunity to better the health of the NPT regime.

2020-05-01-Iran-Peace-Nuclear

Painted stairs in Tehran, Iran symbolizing hope. Photo by Fatemeh Bahrami/Anadolu Agency/Getty Images.

Despite face-to-face diplomatic meetings being increasingly rare during the current disruption, COVID-19 will ultimately force a redefinition of national security and defence spending priorities, and this could provide the possibility of an improved political climate at RevCon when it happens in 2021.

With US presidential elections due in November and a gradual engagement growing between the EU and Iran, there could be a new context for more cooperation between states by 2021. Two key areas of focus over the coming months will be the arms control talks between the United States and Russia, and Iran’s compliance with the 2015 Joint Comprehensive Plan of Action (JCPOA), also known as the Iran Nuclear Deal.

It is too early to discern the medium- and longer-term consequences of COVID-19 for defence ministries, but a greater focus on societal resilience and reinvigorating economic productivity will likely undercut the rationale for expensive nuclear modernization.

Therefore, extending the current New START (Strategic Arms Reduction Treaty) would be the best, most practical option to give both Russia and the United States time to explore more ambitious multilateral arms control measures, while allowing their current focus to remain on the pandemic and economic relief.

Continuing distrust

But with the current treaty — which limits nuclear warheads, missiles, bombers, and launchers — due to expire in February 2021, the continuing distrust between the United States and Russia makes this extension hard to achieve, and a follow-on treaty even less likely.

Prospects for future bilateral negotiations are hindered by President Donald Trump’s vision for a trilateral arms control initiative involving both China and Russia. But China opposes this on the grounds that its nuclear arsenal is far smaller than that of the two others.

While there appears to be agreement that the nuclear arsenals of China, France, and the UK (the NPT nuclear-weapons states) and those of the states outside the treaty (India, Pakistan, North Korea, and Israel) will all have to be taken into account going forward, a practical mechanism for doing so proves elusive.

If Joe Biden wins the US presidency he seems likely to pursue an extension of the New START treaty and could also prevent a withdrawal from the Open Skies treaty, the latest arms control agreement targeted by the Trump administration.

Under a Biden administration, the United States would also probably re-join the JCPOA, provided Tehran returned to strict compliance with the deal. Biden could even use the team that negotiated the Iran deal to advance the goal of denuclearization of the Korean peninsula.

For an NPT regime already confronted by a series of longstanding divergences, it is essential that Iran remains a signatory especially as tensions between Iran and the United States have escalated recently — due to the Qassim Suleimani assassination and the recent claim by Iran’s Revolutionary Guard Corps to have successfully placed the country’s first military satellite into orbit.

This announcement raised red flags among experts about whether Iran is developing intercontinental ballistic missiles due to the dual-use nature of space technology. The satellite launch — deeply troubling for Iran’s neighbours and the EU countries — may strengthen the US argument that it is a cover for the development of ballistic missiles capable of delivering nuclear weapons.

However, as with many other countries, Iran is struggling with a severe coronavirus crisis and will be pouring its scientific expertise and funds into that rather than other efforts — including the nuclear programme.

Those European countries supporting the trading mechanism INSTEX (Instrument in Support of Trade Exchanges) for sending humanitarian goods into Iran could use this crisis to encourage Iran to remain in compliance with the JCPOA and its NPT obligations.

France, Germany and the UK (the E3) have already successfully concluded the first transaction, which was to facilitate the export of medical goods from Europe to Iran. But the recent Iranian escalatory steps will most certainly place a strain on the preservation of this arrangement.

COVID-19 might have delayed Iran’s next breach of the 2015 nuclear agreement but Tehran will inevitably seek to strengthen its hand before any potential negotiations with the United States after the presidential elections.

As frosty US-Iranian relations — exacerbated by the coronavirus pandemic — prevent diplomatic negotiations, this constructive engagement between the E3 and Iran might prove instrumental in reviving the JCPOA and ensuring Iran stays committed to both nuclear non-proliferation and disarmament.

While countries focus their efforts on tackling the coronavirus pandemic, it is understandable resources may be limited for other global challenges, such as the increasing risk of nuclear weapons use across several regions.

But the potential ramifications of the COVID-19 crisis for the NPT regime are profound. Ongoing tensions between the nuclear-armed states must not be ignored while the world’s focus is elsewhere, and the nuclear community should continue to work together to progress nuclear non-proliferation and disarmament, building bridges of cooperation and trust that can long outlast the pandemic.




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Delivering Concrete Climate Change Action

Conference

Towards 2015

21 October 2013 - 9:30am to 22 October 2013 - 3:30pm

Chatham House, London

Overview

Speakers

Press registration

Sponsors

Media partners

Venue and accommodation

Agenda

Audience profile

Over the past five years, the political conditions for a global agreement on climate change have shifted. There is today growing consensus that responding to a changing climate will require multi-level collaboration and new alliances.

In the run-up to the deadline for a new international climate change agreement in 2015, the 17th Annual Chatham House Conference on Climate Change will focus on workable solutions that will help accelerate global decarbonization.

This conference will ask:

  • What will a global deal in 2015 look like? What are the key components of a shared vision? What elements do developing and developed countries need in order to reach agreement?

  • How can the emerging international climate change regime – comprising voluntary partnerships, formal negotiations and business coalitions – deliver the necessary reductions in greenhouse gas emissions?

  • To what extent will new energy realities affect the politics of climate change?

  • What practical lessons can be learned from existing carbon mitigation and adaptation policies?

  • How can the international community harness progressive leadership?

Registration

  • Michael Anderson

    • Chief Executive Officer
  • The Rt Hon Gregory Barker MP

    • Minister of State for Energy and Climate Change
  • Frances Beinecke

    • President
  • Tim Benton

    • UK Champion for Global Food Security and Professor of Population Ecology
  • Sam Bickersteth

    • Chief Executive
  • Tony De Brum

    • Minister-in-Assistance to the President
  • Giles Dickson

    • VP Environmental Policies and Global Advocacy
  • Reid Detchon

    • Vice President, Energy and Climate
  • Alfred Evans

    • Chief Executive Officer
  • Christiana Figueres

    • Executive Secretary
  • Marcin Korolec

    • Minister of Environment, Poland
  • Kate Hampton

    • Executive Director, Climate Change
  • Cameron Hepburn

    • Professor of environmental economics, Smith School and INET at Oxford Martin School, University of Oxford, and
  • David Hone

    • Climate Change Advisor
  • Pa Ousman Jarju

    • Special Envoy for Climate Change
  • Sir David King

    • Foreign Secretary’s Special Representative for Climate Change
  • Martin Khor

    • Director
  • Johan Kuylenstierna

    • Deputy-Director, Stockholm Environment Institute
  • James Leaton

    • Project Director
  • Bernice Lee

    • Research Director, Energy, Environment and Resources
  • Nick Mabey

    • Chief Executive Officer
  • Amina Mohammed

    • Special Adviser on Post-2015 Development Planning
  • Jennifer Morgan

    • Director of the Climate and Energy Program
  • Admiral Neil Morisetti

    • Foreign Secretary’s Special Representative for Climate Change
  • Mutsuyoshi Nishimura

    • Visiting Research Fellow, Japan Institute of International affairs
  • Dr Atiur Rahman

    • Governor
  • John Schellnhuber

    • Founding Director
  • Todd Stern

    • Special Envoy for Climate Change
  • Kelly Rigg

    • Executive Director
  • Laurence Tubiana

    • Director
  • Fraser Thompson

    • Senior Fellow
  • Dominic Waughray

    • Senior Director and Head of Environmental Initiatives
  • Farhana Yamin

    • Associate Fellow

This conference will be held under the Chatham House Rule. Information for journalists
Press can request a press pass using the form below.

If you are interested in becoming a sponsor for this event, please contact George Woodhams on +44 (0)20 7957 5732 or email gwoodhams@chathamhouse.org.


 

 

 

 

 

 

 

 

 

 

 

 

Venue

Chatham House

conferences@chathamhouse.org

Telephone: +44 (0)20 7957 5729
Fax: +44 (0)20 7957 5710


If you wish to book the venue for your event please phone +44 (0)20 7314 2764


Conference Unit
Chatham House
10 St James's Square
London
SW1Y 4LE
UK


Accommodation

Although we cannot book accommodation for delegates, we have arranged a reduced rate at some nearby hotels, where you can book your own accommodation. Please inform the hotel that you will be attending a conference at Chatham House (The Royal Institute of International Affairs) to qualify for the Institute's reduced rate.

Please note all rates are subject to availability.

Flemings Mayfair
Half Moon Street
Mayfair
London W1Y 7RA
Tel: + 44 (0)20 7499 2964
Fax: + 44 (0)20 7499 1817
Standard Single £190 + VAT

The Cavendish London
81 Jermyn Street
London
SW1U 6JF
Tel: + 44 (0)20 7930 2111
Fax: + 44 (0)20 7839 2125
Standard Single £205 + VAT

To book The Cavendish online

The Stafford London by Kempinski
St James's Place
London
SW1A 1NJ
Tel: 020 7518 1125
Fax: 020 7493 7121
Standard Single £230 +VAT

Monday 21 October 2013

Session One
Bridging the Gap Between Science and Policy
09:00 - 10:10

  • What are the latest findings from climate science and the IPCC? 
  • Is the world on track for global decarbonisation? Is dangerous anthropogenic climate change avoidable?
  • To what extent are future climate risks sufficiently incorporated into policy thinking or investment strategies?

Welcome Address
Bernice Lee, Research Director, Energy, Environment and Resources, Chatham House

Chair
Michael Anderson, Chief Executive Officer, Children’s Investment Fund Foundation  

Keynote Address
Professor Hans Joachim Schellnhuber, Founding Director, Potsdam Institute for Climate Impact Research (PIK)

Speakers
Professor Tim Benton, UK Champion for Global Food Security and Professor of Population Ecology, Leeds University

Sir David King, Foreign Secretary’s Special Representative for Climate Change

Questions and Discussion

10:10 - 10:40   Refreshments

Session Two
Global Deal in 2015: Challenges and Prospects
10:40 - 12:40

  • What will a global deal in 2015 look like? Will there be specific targets or non-binding sets of approaches? What are the building blocks?
  • What is the value and track record of different kind of climate initiatives? For example, how successful are formal agreements compared to voluntary partnerships; climate-driven aid; or business coalitions? 
  • What are the main functions and institutions of the evolving international climate regime? What is the role of the UNFCCC? Is reform an option given the timeframe? What is the role for groupings like the G20 or the G8?

Chair
Bernice Lee, Research Director, Energy, Environment and Resources, Chatham House
 
Keynote Addresses
Christiana Figueres, Executive Secretary, United Nations Framework Convention on Climate Change (UNFCCC) (on the record)

Marcin Korolec, Minister of Environment, Poland and President, COP 19, UN Framework Convention on Climate Change (UNFCCC)

Questions and Discussion

Speakers
Nick Mabey, Chief Executive Officer, E3G

Farhana Yamin, Associate Fellow, Chatham House

Laurence Tubiana, Director, The Institute for Sustainable Development and International Relations (IDDRI)

Questions and Discussion

1240 - 14:00   Lunch

Chair
Bernice Lee, Research Director, Energy, Environment and Resources, Chatham House

Keynote Address
Gregory Barker, Minister of State for Energy and Climate Change, United Kingdom (on the record)

Questions and Discussion

Session Three
Climate-Resilient Development: Views from Developing Countries
14:30 - 16:10

  • What are the drivers of domestic climate action in developing countries?
  • What do developing countries need from the international climate regime: e.g. with respect to finance, ‘loss and damage’ and disaster preparedness? 
  • How will the politics among developing countries evolve? Has the G77 been eclipsed by the emergence of BASIC and other developing country alliances?

Chair
Sam Bickersteth, Chief Executive, The Climate and Development Knowledge Network (CDKN)

Keynote Addresses
Dr Atiur Rahman, Governor, Bangladesh Bank

Senator Tony deBrum, Minister-in-Assistance to the President, Republic of Marshall Islands

Questions and Discussion

Speakers
Martin Khor, Director, South Centre

Pa Ousman Jarju, Special Envoy for Climate Change, Republic of the Gambia

Questions and Discussion

16:10 - 16:30    Refreshments

Session Four
Preparing for 2015: The Role of Major Economies
16:30 - 17:30

  • Do countries have clear understandings of how climate risks will reshape their national interests? How will these risks affect other agendas e.g. future economic competitiveness, resource security, public health, foreign policy, or disaster preparedness?
  • How will major countries manage competing domestic priorities when preparing their national positions in the run-up to 2015? What is the evolving trilateral US-China-EU dynamic? Can the EU provide the necessary leadership?
  • Are national investment systems capable of scaling up financing to deliver climate action in key countries like US, EU, China and India?

Chair
Bernice Lee, Research Director, Energy, Environment and Resources, Chatham House

Speakers
David Hone, Climate Change Adviser, Shell

Jennifer Morgan, Director of the Climate and Energy Program, World Resources Institute 

Rear Admiral Neil Morisetti, Foreign Secretary’s Special Representative for Climate Change, United Kingdon

Mutsuyoshi Nishimura,  Visiting Research Fellow, Japan Institute of International affairs and Former Special Adviser to the Cabinet in charge of Climate Change, Japan 

Questions and Discussion

17:30 End of day one and drinks reception hosted by Chatham House


DAY TWO
Tuesday 22 October
09:30 - 15:10

Session Five
The Changing Global Energy Landscape: Implications for Decarbonization
09:30 - 10:45

  • What are the implications of the ‘golden age of gas’? What will growing coal use in many developing economies mean for climate politics?
  • What is the prospect for scaling up renewable investments – given the lessons learned vis-à-vis the scale, speed and cost of low carbon technologies over the past five years?
  • What are the contributions of off-grid, distributive generation and other demand side measures like efficiency?

Chair
David Hone, Climate Change Adviser, Shell

Moderated Panel Discussion
Reid Detchon, Vice President for Energy and Climate, United Nations Foundation

Giles Dickson, Vice President, Environmental Policies & Global Advocacy, Alstom 

Antony Froggatt, Senior Research Fellow, Chatham House

Questions and Discussion

10:45 - 11:15     Refreshments

Session Six
Climate Policy and Finance: The Emerging Toolkit
11:15 - 12:30

  • What is the track record of policies and measures to tackle CO2 emissions – from carbon markets, standards and subsidies removal to taxation? What is the progress on tackling non-CO2 greenhouse gases? 
  • The cost of climate impacts has been escalating. What are the emerging tools (e.g. disaster preparedness, climate-proof aid or insurance) for managing the impacts? 
  • What is the role of public versus private finance for different countries? What is the role of multilateral financing institutions in facilitating the increasingly large finance flows required?

Chair
Cameron Hepburn, Professor of Environmental Economics, Smith School and INET at Oxford Martin School, University of Oxford, and Professorial Research Fellow at the Grantham Research Institute at the LSE

Speakers
Dr Johan Kuylenstierna, Deputy- Director, Stockholm Environment Institute, University of York

Cameron Hepburn, Professor of environmental economics, Smith School and INET at Oxford Martin School, University of Oxford, and Professorial Research Fellow at the Grantham Research Institute at the LSE

James Leaton, Project Director, Carbon Tracker 

Fraser Thompson, Senior Fellow, McKinsey Global Institute

Questions and Discussion

12:30 -13:30    Lunch

13.:30 -14:00

Chair
Bernice Lee
, Research Director, Energy, Environment and Resources, Chatham House

Keynote Address
Todd Stern
, Special Envoy for Climate Change, United States Department of State

Questions and Discussion

Session Seven
Building the Progressive Conditions for 2015
14:00 - 15:10

  • Can the international community harness progressive leadership – through coalitions of governments, businesses and/or NGOs? 
  • What are the political or mobilisation strategies needed to tackle domestic climate scepticism, build progressive coalitions and neutralise vested interests at different levels? 
  • What are the implications of the post-2015 development discussions for climate change? 

Chair
Dominic Waughray, Senior Director, Head of Environmental Initiatives, World Economic Forum

Moderated Panel Discussion
Frances Beinecke, 
President, Natural Resources Defense Council 

Alfred Evans, Chief Executive Officer, Climate Change Capital

Kate Hampton, Executive Director, Climate Change, Children's Investment Fund Foundation 

Amina Mohammed, Special Adviser on Post-2015 Development Planning, United Nations

Questions and Discussion

15:10 Close of Conference


© The Royal Institute of International Affairs 2013

This conference will offer a unique opportunity to network with senior officials from businesses, government, NGO's and academic institutions.

Our previous Climate Change conferences saw delegates from companies and institutions such as:

Accenture
AEA Energy & Environment
Agulhas
ArcelorMittal
Association of Asia Pacific Airlines (AAPA)
Atkins Ltd
BASF plc
Bayerngas Norge AS
Beetle Capital
BG Group plc
BHP Billiton
BIRA-IASB
Booz & Co
BP plc
British Council
BT Group plc
Cairn Energy plc
Cambridge Centre for Energy Studies
Cambridge Programme for Sustainable Leadership
Carbon Capture and Storage Association
Carbon Leapfrog
Carbon Trust
Caritas Internationalis
Catholic Fund for Overseas Development (CAFOD)
CH2M Hill
Chamber of Shipping
Chevron Ltd
Chubu Electric Power Co Inc
ClientEarth
Clifford Chance LLP
Climate & Development Knowledge Network (CDKN)
Climate Action Network (CAN)
Climate and Health Council
Climate Secure
Coalition for an International Court for the Environment (ICE Coalition)
Compassion in World Farming (CIWF)
Conocophillips (UK) Ltd
Control Risks
Co-operative Group
Cranfield University
Deloitte Consulting LLP
Department for Business, Innovation & Skills (BIS)
Department for International Development (DFID)
Department of Energy and Climate Change (DECC)
Ecofys UK Ltd
Ecologic Institute
EDF Energy
Energy Charter Secretariat
Energy Technologies Institute
Eni S.p.A
Environment Agency
Environmental Law Foundation (ELF)
Environmental Protection Agency (EPA)
Environmental Resources Management (ERM)
ENWORKS
Ernst & Young
Ethical Investment Research Services Ltd (EIRIS)
European Bank For Reconstruction & Development
European Commission (Directorate General for Enterprise and Industry)
European Parliament
ExxonMobil International Ltd
Fauna & Flora International
FIA Foundation for the Automobile and Society
Finnish Forest Association
Foreign and Commonwealth Office (FCO)
Forestry Commission
Friends of the Earth
Genesis Investment Management LLP
GLG Partners LP
Global CCS Institute
Global Humanitarian Forum
Global Sustainability Institute
Global Witness
Globeleq Ltd
Grantham Research Institute on Climate Change and the Environment, LSE
Greater Manchester Chamber of Commerce
Greenpeace International
Herbert Smith Freehills LLP
HM Treasury
Imperial College London
INPEX Corporation
Institute for Public Policy Research (IPPR)
Institutional Investors Group on Climate Change (IIGCC)
International Association of Oil & Gas Producers
International Council on Mining and Metals
International Finance Corporation (IFC)
International Institute for Environment and Development (IIED)
International Organization for Standardization (ISO)
Japan External Trade Organization (JETRO)
Joseph Rowntree Foundation
JPMorgan
King's College London
KPMG
Kuwait Petroleum Corporation
London Assembly
London Metropolitan University
London School of Economics and Political Science (LSE)
Maersk Group
Massey University
McKinsey & Company
METREX
Ministere des Affaires Etrangeres, France
Ministry of Defence (Development, Concepts and Doctrine Centre)
Ministry of Foreign Affairs, Netherlands
Ministry of Foreign Affairs, Finland
Ministry of Foreign Affairs, Poland
Ministry of Infrastructure and the Environment
Mitsubishi Corporation
National Farmers' Union
National Round Table on the Environment and the Economy
Netherlands Development Finance Company (FMO)
NEXUS Singapore
Office of National Assessments
Ogilvy
Open Society Foundation
Overseas Development Institute (ODI)
Oxford University
Plan UK
PricewaterhouseCoopers LLP
Privy Council Office
Progressio
Quaker Peace and Social Witness
Québec Government Office
Renewable Energy and Energy Efficiency Partnership (REEEP)
Renewable Energy Systems Ltd (RES)
Rolls-Royce International Ltd
RWE Power AG
Save the Children UK
SCA, Svenska Cellulosa Aktiebolaget
School of Oriental and African Studies (SOAS)
Standard Chartered Bank plc
Statoil (UK) Ltd
SustainAbility Ltd
Swedish Defence Research Agency (FOI)
Swiss Agency for Development and Cooperation SDC
Task Consult
Texas A&M University
The 40 Foundation
The Climate Group
The Gold Standard Foundation
The Norwegian Institute for Nature Research
The Open University
The Prince of Wales Corporate Leader Group
The Royal Society
The Saudi Fund For Development
Tokyo Electric Power Company
Total Holdings UK Ltd
UK Chamber of Shipping
UK Collaborative on Development Sciences (UKCDS)
United Nations Environment Programme (UNEP)
University College London (UCL)
University of Cambridge
University of East Anglia (School of Environmental Sciences)
University of Edinburgh
University of Oxford (Department of Politics and International Relations)
US Department of State
USAID
Warwick Business School
WaterAid
World Coal Association
World Coal Institute
World Economic Forum
World Society for the Protection of Animals (WSPA)
World Vision UK
WWF-UK
Xynteo Ltd
Yorkshire Forward




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Climate Change: Raising Ambition, Delivering Results

Conference

3 November 2014 - 9:30am to 4 November 2014 - 1:15pm

Chatham House, London

Overview

Agenda

Speakers

Pricing

Media partners

Sponsors

Audience profile

Venue and accommodation

Press registration

Climate change is climbing the political agenda. Extreme weather has raised questions in public discourse about the role of anthropogenic warming and concerns about its future impacts; slowdowns in emerging economies and sluggish recoveries in the developed world mean debates about the impact of climate policies on energy bills and competitiveness have assumed particular significance. Against this background, governments are gearing up for a crucial series of agreements in 2015 with climate change at their core. The international community must agree new global sustainable development goals, a new framework on disaster risk reduction and, at the 21st UN Framework Convention on Climate Change (UNFCCC) meeting of the Conference of Parties (COP 21) in Paris, a new global deal on climate change. 

The 18th Annual Chatham House Conference on Climate Change will take stock of developments in 2014, including the latest science, the findings of high-level commissions, initiatives from the business community and the UN Secretary-General’s High Level Summit at the end of September. Looking forward to COP 20 in Lima and beyond, this conference will examine opportunities to raise ambition and convert this into results.

In particular, it will:

  • Review the latest science on climate risk and the implications for business, society and politics 
     
  • Examine the benefits of a low carbon economy, and assess the costs of climate action and where they fall 
     
  • Discuss concrete measures to decarbonize key sectors and the barriers to action
     
  • Identify the critical path to the UNFCCC’s Conference of the Parties (COP 21) in 2015, and look at whether, and how, support for ambitious action can be built among publics, business and politicians


The Chatham House Rule
To enable as open a debate as possible, this conference will be held under the Chatham House Rule.

Twitter
Suggested hashtag: #CHclimate

DAY ONE
Monday 3 November

Session One
Taking Stock and Mapping the Road Ahead
09:30-11:15

  • What was achieved at the UN Secretary General’s High Level Summit in September? 
  • What is the outlook for COP 20 in Lima, and how can ambition be increased?
  • How will success at COP 21 in Paris be defined?

Chair
Rob Bailey, Acting Research Director, Energy, Environment and Resources, Chatham House

Keynote Address
Manuel Pulgar-Vidal, Minister of State for the Environment, Peru; President, COP 20, UN Framework for the Convention on Climate Change (UNFCCC) (on the record)

Amber Rudd MP, Parliamentary Under Secretary of State, Department of Energy and Climate Change, United Kingdom (on the record)

Questions and Discussion

Chair
Jennifer Morgan, Director, Climate and Energy Programme, World Resources Institute (WRI) 

Speakers

Selwin Hart, Director, Secretary-General's Climate Change Support Team, United Nations

Dr Halldór Thorgeirsson, Director for Strategy, UN Framework for the Convention on Climate Change (UNFCCC)

Leena Srivastava, Executive Director, The Energy and Resource Institute (TERI) 

Paul Watkinson, Head of Climate Negotiation Team, Ministry of Ecology, Sustainable Development and Energy, France

Questions and Discussion

11:15-11:45 Refreshments

Session Two
Low Carbon Economy: Costs and Benefits
11:45-13:00 

  • What are the economic and social opportunities and benefits of a low carbon economy? Where do these occur? How much are they worth?
  • What are examples of leadership among governments and business? What is needed to accelerate the transition and translate ambition into results?
  • What has been the impact of climate policies on economic competitiveness? Which economies and sectors have been most affected? How has this influenced national and international climate politics?
Chair's Opening Remarks
Marianne Fay, Chief Economist, Climate Change Group, The World Bank
Keynote Panel Discussion

Jeremy Oppenheim, Programme Director, New Climate Economy, Global Commission on the Economy and Climate 

Jos Delbeke, Director General for Climate Action, European Commission 

Dr Qi Ye, Director, Brookings-Tsinghua Center for Public Policy; Professor of Environmental Policy and Management at Tsinghua University’s School of Public Policy and Management

Jeremy Bentham, Vice President, Global Business Environment, Shell

Questions and Discussion

13:00-14:00 Lunch

Session Three
Concrete Steps to Action: Finance and Achieving Net Zero 

There is growing interest in the concept of net zero carbon emissions, for businesses, sectors and even countries. This session will examine the feasibility of net zero for the power and transport sectors, and for buildings and cities.

Chair
Shane Tomlinson, Senior Research Fellow, Energy, Environment and Resources, Chatham House

Opening Discussion
Manfred Konukiewitz, Co-Chair, the Green Climate Fund 

Matthew Kotchen, Professor of Economics, Yale University 

Farhana Yamin, Associate Fellow, Chatham House

Power and Transport
14:45-15:45

  • What do decarbonization roadmaps for the power and transport sectors look like? Is net zero feasible? If so, by when and how? What are the challenges posed by increasing renewable penetration, and how can they be managed? What are the implications of vehicle electrification for the power sector?
  • What are the implications for infrastructure and investment?

Chair
Shane Tomlinson, Senior Research Fellow, Energy, Environment and Resources, Chatham House

Speakers
Abyd Karmali, Managing Director, Climate Finance, Bank of America Merrill Lynch

Dries Acke, Policy Manager, European Climate Foundation (Belgium) 

Olivier Paturet, General Manager,  Zero Emissions Strategy, Nissan Europe

Stefan Raubenheimer, Co-Founder and Director, South South North;  Co-Director, MAPS Programme 

Questions and Discussion

15:45-16:15 Refreshments

Buildings and Cities
16:15-17:15

  • What is the state of the art for low carbon building; how can this be rolled out at scale? 
  • How can decarbonization objectives be incorporated into urban planning and regulation?
  • How are the challenges and needs different for developed and developing countries? 

Chair
Farhana Yamin, Associate Fellow, Energy, Environment and Resources, Chatham House

Speakers
Ed Mazria, Founder and CEO, Architecture 2030

Tony Mallows, Director, Masdar City 

Questions and Discussion

17:15 Close of day and drinks reception

DAY TWO
Tuesday 4 November

Session Four 
Climate Impacts
9:30-11:15 

Chair
Sir David King, Foreign Secretary's Special Representative for Climate Change, United Kingdom

Keynote Addresses
HE Belete Tafere, Minister, Ministry of Environment Protection and Forestry, Ethiopia (on the record)

Professor Hans Joachim Schellnhuber, Founding Director, Potsdam Institute for Climate Impact Research (on the record)

  • What climate impacts are already being witnessed? Are these in line with expectations? What is the current state of attribution analysis?
  • What are the implications for climate politics?
  • What are the expected social, economic and environmental impacts under different climate scenarios? What is the most recent science since the deadline for Working Group II of the Intergovernmental Panel on Climate Change’s Fifth Assessment Report?  
  • Which countries and sectors are most vulnerable? What are governments and businesses doing to adapt?


Chair
Sir David King, Foreign Secretary's Special Representative for Climate Change, United Kingdom

Speakers
Chris Field, Founding Director, Department of Global Ecology, Carnegie Institution of Science, Co-Chair of Working Group II of the IPCC’s Fifth Assessment Report 

Professor Myles Allen, Leader of ECI Climate Research Programme and Professor of Geosystem Science, University of Oxford 

Nick Mabey, Director, E3G 

Oilver Bettis, Chair, Resource and Environment Board, Institute and Faculty of Actuaries

Questions and Discussion

11:15 - 11.45 Refreshments

Session Five
The Conditions for Action
11:45 - 13:00

  • What is the current state of public support for climate action? What shapes attitudes and beliefs? How does this vary by country? 
  • What can create political ambition, nationally and internationally?
  • What role can different stakeholders play in catalysing climate action?
  • What immediate obstacles need to be overcome and what lessons can be learned from recent success? 
Chair
Simon Maxwell, Executive Chair, Climate Development Knowledge Network
Keynote Address
Bill McKibben, President and Co-Founder, 350.org (on the record)

Panel Discussion
Antonio Hill, Executive Director, Global Campaign for Climate Action

Michael Jacobs, Senior Adviser on International Climate Policy, The Institute for Sustainable Development and International Relations  

Jennifer Morgan, Director, Climate and Energy Programme, World Resources Institute (WRI) 

Sergio Margulis, National Secretary of Sustainable Development, Secretariat of Strategic Affairs of the Presidency of Brazil 

Sir David King, Foreign Secretary's Special Representative for Climate Change, United Kingdom

Questions and Discussion

Closing remarks
Rob Bailey, Acting Research Director, Energy, Environment and Resources, Chatham House

1
3:10 End of conference and lunch

 © The Royal Institute of International Affairs 2014

Keynote Speakers

Speakers

Dries Acke

Policy Manager, European Climate Foundation (Belgium)

Myles Allen

Coordinating Lead Author, Intergovernmental Panel on Climate Change Special Report on Global Warming of 1.5 °C; Professor of Geosystem Science, University of Oxford

Oliver Bettis

Chair, Institute and Faculty of Actuaries' Resource and Environment Board

Marianne Fay

Chief Economist, Climate Change Group, The World Bank

Chris Field

Founding Director, Department of Global Ecology, Carnegie Institution of Science

Selwin Hart

Director, Secretary-General's Climate Change Support Team, United Nations

Antonio Hill

Executive Director, Global Campaign for Climate Action

Michael Hogan

Senior Adviser, Regulatory Assistance Project

Professor Michael Jacobs

Senior Adviser on International Climate Policy, The Institute for Sustainable Development and International Relations

Abyd Karmali

Managing Director, Climate Finance, Bank of America Merrill Lynch

Sir David King

Foreign Secretary’s Special Representative for Climate Change

Manfred Konukiewitz

Co-Chair, The Green Climate Fund

Matthew Kotchen

Professor of Economics, Yale University

Nick Mabey

Co-Founding Director and Chief Executive, E3G

Antony Mallows

Director, Masdar City

Sergio Margulis

National Secretary of Sustainable Development, Secretariat of Strategic Affairs of the Presidency, Brazil

Simon Maxwell

Executive Chairman, Climate and Development Knowledge Network

Edward Mazria

Founder and CEO, Architecture 2030

Jennifer Morgan

Executive Director, Greenpeace International

Olivier Paturet

General Manager, Zero Emissions Strategy, Nissan Europe

Stefan Raubenheimer

Co-Founder and Director, South South North; Co-Director, MAPS Programme

Jose-Manuel Sanoval

Coordinator, Colombian Low Carbon Development Strategy (CLCDS) and Mitigation Action Plans and Scenarios (MAPS)

Leena Srivastava

Hony. Executive Director (Operations), The Energy and Resources Institute (TERI)

Halldór Thorgeirsson

Director for Strategy, UN Framework for the Convention on Climate Change

Paul Watkinson

Head of Climate Negotiation Team, Ministry of Ecology, Sustainable Development and Energy, France

Farhana Yamin

Associate Fellow, Energy, Environment and Resources Programme

[node:event_chair]

Pricing

For any questions about rates, please call +44 (0)20 7314 2782.

                      FULL RATE
EXCL. VATINCL. VAT
Major corporate member rates
All organizations£595£714 
Corporate member rates
Commercial organizations£1,295£1,554
Government departments£775£930
NGOs and academics£495£594
Standard rates
Commercial organizations£1,445£1,734 
Government departments£845£1,014
NGOs and academics£550£660

This conference will offer a unique opportunity to network with senior officials from businesses, government, NGO's and academic institutions.

Our previous Climate Change conferences saw delegates from companies and institutions such as:

Accenture
AEA Energy & Environment
Agulhas
ArcelorMittal
Association of Asia Pacific Airlines (AAPA)
Atkins Ltd
Bank of America Merrill Lynch
BASF plc
Bayerngas Norge AS
Beetle Capital
BG Group plc
BHP Billiton
BIRA-IASB
BirdLife
Booz & Co
BP plc
British Council
BT Group plc
CAFOD
Cairn Energy plc
Cambridge Centre for Energy Studies
Cambridge Programme for Sustainable Leadership
Carbon Capture and Storage Association
Carbon Leapfrog
Carbon Trust
Caritas Internationalis
Catholic Fund for Overseas Development (CAFOD)
CH2M Hill
Chevron Ltd
Chubu Electric Power Co Inc
City of London
ClientEarth
Clifford Chance LLP
Climate & Development Knowledge Network (CDKN)
Climate Action Network (CAN)
Climate and Health Council
Climate Secure
Coalition for an International Court for the Environment (ICE Coalition)
Compassion in World Farming (CIWF)
Conocophillips (UK) Ltd
Control Risks
Co-operative Group
Cranfield University
Deloitte Consulting LLP
Department for Business, Innovation & Skills (BIS)
Department for International Development (DFID)
Department of Energy and Climate Change (DECC)
Ecofys UK Ltd
Ecologic Institute
EDF Energy
Energy Charter Secretariat
Energy Technologies Institute
Eni S.p.A
Environment Agency
Environmental Law Foundation (ELF)
Environmental Protection Agency (EPA)
Environmental Resources Management (ERM)
ENWORKS
Ernst & Young
Ethical Investment Research Services Ltd (EIRIS)
European Bank For Reconstruction & Development
European Commission (Directorate General for Enterprise and Industry)
European Parliament
ExxonMobil International Ltd
Fauna & Flora International
FIA Foundation for the Automobile and Society
Finnish Forest Association
Foreign and Commonwealth Office (FCO)
Forestry Commission
Friends of the Earth
Genesis Investment Management LLP
GLG Partners LP
Global CCS Institute
Global Humanitarian Forum
Global Sustainability Institute
Global Witness
Globeleq Ltd
Grantham Research Institute on Climate Change and the Environment, LSE
Greater Manchester Chamber of Commerce
Greenpeace International
Herbert Smith Freehills LLP
HM Treasury
Imperial College London
INPEX Corporation
Institute for Public Policy Research (IPPR)
Institutional Investors Group on Climate Change (IIGCC)
International Association of Oil & Gas Producers
International Council on Mining and Metals
International Finance Corporation (IFC)
International Institute for Environment and Development (IIED)
International Organization for Standardization (ISO)
Japan External Trade Organization (JETRO)
Joseph Rowntree Foundation
JPMorgan
King's College London
KPMG
Kuwait Petroleum Corporation
London Assembly
London Metropolitan University
London School of Economics and Political Science (LSE)
Maersk Group
Massey University
McKinsey & Company
Met Office
METREX
Ministere des Affaires Etrangeres, France
Ministry of Defence (Development, Concepts and Doctrine Centre)
Ministry of Foreign Affairs, Netherlands
Ministry of Foreign Affairs, Finland
Ministry of Foreign Affairs, Poland
Ministry of Infrastructure and the Environment
Mitsubishi Corporation
National Farmers' Union
National Round Table on the Environment and the Economy
Netherlands Development Finance Company (FMO)
NEXUS Singapore
Nordic Council
Office of National Assessments
Ogilvy
Open Society Foundation
Overseas Development Institute (ODI)
Oxford University
Plan UK
PricewaterhouseCoopers LLP
Privy Council Office
Progressio
Quaker Peace and Social Witness
Québec Government Office
Renewable Energy and Energy Efficiency Partnership (REEEP)
Renewable Energy Systems Ltd (RES)
Rolls-Royce International Ltd
RWE Power AG
Save the Children UK
SCA, Svenska Cellulosa Aktiebolaget
School of Oriental and African Studies (SOAS)
Shell
Standard Chartered Bank plc
Statoil (UK) Ltd
SustainAbility Ltd
Swedish Defence Research Agency (FOI)
Swiss Agency for Development and Cooperation SDC
Task Consult
Texas A&M University
The 40 Foundation
The Climate Group
The Gold Standard Foundation
The Norwegian Institute for Nature Research
The Open University
The Prince of Wales Corporate Leader Group
The Royal Society
The Saudi Fund For Development
Tokyo Electric Power Company
Total Holdings UK Ltd
UK Chamber of Shipping
UK Collaborative on Development Sciences (UKCDS)
United Nations Environment Programme (UNEP)
University College London (UCL)
University of Cambridge
University of East Anglia (School of Environmental Sciences)
University of Edinburgh
University of Oxford (Department of Politics and International Relations)
US Department of State
USAID
Warwick Business School
WaterAid
World Coal Association
World Coal Institute
World Economic Forum
World Society for the Protection of Animals (WSPA)
World Vision UK
WWF-UK
Xynteo Ltd
Yorkshire Forward

Venue

Chatham House
10 St James's Square
London
SW1Y 4LE
UK

conferences@chathamhouse.org

Telephone: +44 (0)20 7957 5729
Fax: +44 (0)20 7957 5710

If you wish to book the venue for your event please phone +44 (0)20 7314 2764


Directions

The nearest tube station is Piccadilly Circus which is on the Piccadilly and the Bakerloo Underground lines. From Piccadilly follow Regent Street southwards towards Pall Mall and take the first road on the right called Jermyn Street. Duke of York Street is the second road on the left and leads to St James's Square. Chatham House is immediately on your right.

Map

Accommodation

Although we cannot book accommodation for delegates, we have arranged a reduced rate at some nearby hotels, where you can book your own accommodation. Please inform the hotel that you will be attending a conference at Chatham House (The Royal Institute of International Affairs) to qualify for the Institute's reduced rate.

Please note all rates are subject to availability.

Flemings Mayfair
Half Moon Street
Mayfair
London W1J 7BH
Tel: + 44 (0)20 7499 2964
Fax: + 44 (0)20 7499 1817
Standard Single from £199 + VAT

The Cavendish London
81 Jermyn Street
London
SW1Y 6JF
Tel: + 44 (0)20 7930 2111
Fax: + 44 (0)20 7839 2125
Standard Single £205 + VAT

To book The Cavendish online

The Stafford London by Kempinski
St James's Place
London
SW1A 1NJ
Tel: 020 7518 1125
Fax: 020 7493 7121
Standard Single £230 +VAT

This conference will be held under the Chatham House Rule. Information for journalists
Press can request a press pass.


Chatham House Conferences

+44 (0)20 7957 5729




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Subscription models and small venues the future

AS ARTISTES and musicians try to manage the situation brought on by COVID-19’s stranglehold on the world and its economy, in the interim, many have resorted to hosting live-stream events. But that only succeeds to a point. Performers retain their...




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Pancreas Pathology of Latent Autoimmune Diabetes in Adults (LADA) in Patients and in a LADA Rat Model Compared With Type 1 Diabetes

Approximately 10% of patients with type 2 diabetes suffer from latent autoimmune diabetes in adults (LADA). This study provides a systematic assessment of the pathology of the endocrine pancreas of patients with LADA and for comparison in a first rat model mimicking the characteristics of patients with LADA. Islets in human and rat pancreases were analyzed by immunohistochemistry for immune cell infiltrate composition, by in situ RT-PCR and quantitative real-time PCR of laser microdissected islets for gene expression of proinflammatory cytokines, the proliferation marker proliferating cell nuclear antigen (PCNA), the anti-inflammatory cytokine interleukin (IL) 10, and the apoptosis markers caspase 3 and TUNEL as well as insulin. Human and rat LADA pancreases showed differences in areas of the pancreas with respect to immune cell infiltration and a changed ratio between the number of macrophages and CD8 T cells toward macrophages in the islet infiltrate. Gene expression analyses revealed a changed ratio due to an increase of IL-1β and a decrease of tumor necrosis factor-α. IL-10, PCNA, and insulin expression were increased in the LADA situation, whereas caspase 3 gene expression was reduced. The analyses into the underlying pathology in human as well as rat LADA pancreases provided identical results, allowing the conclusion that LADA is a milder form of autoimmune diabetes in patients of an advanced age.




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Visa issues delay Sucre's arrival to O's camp

It may take the Orioles a little longer than expected to sift through their crowded catching situation. A club source confirmed that catcher Jesus Sucre is held up by visa issues in his native Venezuela and will report to camp late.




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How scientific are US dietary guidelines?

They have a big impact on the diet of American citizens, and those of most Western nations, so why does the expert advice underpinning US government dietary guidelines not take account of all the relevant scientific evidence asks Nina Teicholz. Read the full investigation: http://www.bmj.com/content/351/bmj.h4962




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"Women deliver, and not only babies"

Katja Iversen, CEO of Women Deliver, joins Rebecca Coombes to explain why the UN sustainable development goals are unachievable if we don't empower women and girls to take control of their health, wellbeing, and reproductive rights. http://womendeliver.org/




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Caring for patients with delirium at the end of their life

Delirium is common in the last weeks or days of life. It can be distressing for patients and those around them. A clinical update explains why successful management involves excluding reversible causes of delirium and balancing drugs that may provoke or maintain delirium while appreciating that most patients want to retain clear cognition at the...




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Mendelian Randomisation - for the moderately intelligent

Mendelian randomisation - it’s a technique that uses the chance distribution of genes in a population, combined with big data sets, to investigate causative relationships. But there are a lot of questions we have in The BMJ about how the technique works - the association between genes and apparently non-biologically mediated behaviours, how much...




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Thoroughly and deliberately targeted; Doctors in Syria

As Syria enters its ninth year of conflict, doctors are struggling to provide health care to a badly damaged country. While dealing with medicine shortages, mass casualties and everything that comes with working in a warzone, healthcare facilities and their staff are also facing an unprecedented number of targeted and often repeated attacks....




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Talk Evidence covid-19 update - pneumonia, guidelines, preprints and testing

For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give...




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Talk Evidence covid-19 update - hydroxy/chloroquinine, prognostic models and facemaskss

For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give...




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Talk evidence covid-19 update: natural history of covid, include patients in guidelines

For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give you...




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Predictive Modeling of Type 1 Diabetes Stages Using Disparate Data Sources

This study aims to model genetic, immunologic, metabolomics, and proteomic biomarkers for development of islet autoimmunity (IA) and progression to type 1 diabetes in a prospective high-risk cohort. We studied 67 children: 42 who developed IA (20 of 42 progressed to diabetes) and 25 control subjects matched for sex and age. Biomarkers were assessed at four time points: earliest available sample, just prior to IA, just after IA, and just prior to diabetes onset. Predictors of IA and progression to diabetes were identified across disparate sources using an integrative machine learning algorithm and optimization-based feature selection. Our integrative approach was predictive of IA (area under the receiver operating characteristic curve [AUC] 0.91) and progression to diabetes (AUC 0.92) based on standard cross-validation (CV). Among the strongest predictors of IA were change in serum ascorbate, 3-methyl-oxobutyrate, and the PTPN22 (rs2476601) polymorphism. Serum glucose, ADP fibrinogen, and mannose were among the strongest predictors of progression to diabetes. This proof-of-principle analysis is the first study to integrate large, diverse biomarker data sets into a limited number of features, highlighting differences in pathways leading to IA from those predicting progression to diabetes. Integrated models, if validated in independent populations, could provide novel clues concerning the pathways leading to IA and type 1 diabetes.




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Downswell reaches out to Central Village - Carry Me singer delivers care packages to community

The wet weather last Saturday (May 2) could not dampen the spirits of award-winning gospel artiste and ordained evangelist Kevin Downswell as he ventured into the St Catherine community of Central Village, where he spent some of his formative years...




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A Novel Model of Diabetic Complications: Adipocyte Mitochondrial Dysfunction Triggers Massive {beta}-Cell Hyperplasia

Obesity-associated type 2 diabetes mellitus (T2DM) entails insulin resistance and loss of β-cell mass. Adipose tissue mitochondrial dysfunction is emerging as a key component in the etiology of T2DM. Identifying approaches to preserve mitochondrial function, adipose tissue integrity, and β-cell mass during obesity is a major challenge. Mitochondrial ferritin (FtMT) is a mitochondrial matrix protein that chelates iron. We sought to determine whether perturbation of adipocyte mitochondria influences energy metabolism during obesity. We used an adipocyte-specific doxycycline-inducible mouse model of FtMT overexpression (FtMT-Adip mice). During a dietary challenge, FtMT-Adip mice are leaner but exhibit glucose intolerance, low adiponectin levels, increased reactive oxygen species damage, and elevated GDF15 and FGF21 levels, indicating metabolically dysfunctional fat. Paradoxically, despite harboring highly dysfunctional fat, transgenic mice display massive β-cell hyperplasia, reflecting a beneficial mitochondria-induced fat-to-pancreas interorgan signaling axis. This identifies the unique and critical impact that adipocyte mitochondrial dysfunction has on increasing β-cell mass during obesity-related insulin resistance.




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PI3K{delta} as a Novel Therapeutic Target in Pathological Angiogenesis

Diabetic retinopathy is the most common microvascular complication of diabetes, and in the advanced diabetic retinopathy appear vitreal fibrovascular membranes that consist of a variety of cells, including vascular endothelial cells (ECs). New therapeutic approaches for this diabetic complication are urgently needed. Here, we report that in cultured human retinal microvascular ECs, high glucose induced expression of p110, which was also expressed in ECs of fibrovascular membranes from patients with diabetes. This catalytic subunit of a receptor-regulated PI3K isoform is known to be highly enriched in leukocytes. Using genetic and pharmacological approaches, we show that p110 activity in cultured ECs controls Akt activation, cell proliferation, migration, and tube formation induced by vascular endothelial growth factor, basic fibroblast growth factor, and epidermal growth factor. Using a mouse model of oxygen-induced retinopathy, p110 inactivation was found to attenuate pathological retinal angiogenesis. p110 inhibitors have been approved for use in human B-cell malignancies. Our data suggest that antagonizing p110 constitutes a previously unappreciated therapeutic opportunity for diabetic retinopathy.




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Retinopathy in a Diet-Induced Type 2 Diabetic Rat Model and Role of Epigenetic Modifications

Type 2 diabetes accounts for 90% of the population with diabetes, and these patients are generally obese and hyperlipidemic. In addition to hyperglycemia, hyperlipidemia is also closely related with diabetic retinopathy. The aim was to investigate retinopathy in a model closely mimicking the normal progression and metabolic features of the population with type 2 diabetes and elucidate the molecular mechanism. Retinopathy was evaluated in rats fed a 45% kcal as fat diet for 8 weeks before administering streptozotocin, 30 mg/kg body weight (T2D), and compared with age- and duration-matched type 1 diabetic rats (T1D) (60 mg/kg streptozotocin). The role of epigenetic modifications in mitochondrial damage was evaluated in retinal microvasculature. T2D rats were obese and severely hyperlipidemic, with impaired glucose and insulin tolerance compared with age-matched T1D rats. While at 4 months of diabetes, T1D rats had no detectable retinopathy, T2D rats had significant retinopathy, their mitochondrial copy numbers were lower, and mtDNA and Rac1 promoter DNA methylation was exacerbated. At 6 months, retinopathy was comparable in T2D and T1D rats, suggesting that obesity exaggerates hyperglycemia-induced epigenetic modifications, accelerating mitochondrial damage and diabetic retinopathy. Thus, maintenance of good lifestyle and BMI could be beneficial in regulating epigenetic modifications and preventing/retarding retinopathy in patients with diabetes.




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Guidelines for Good Governance in Emerging Oil and Gas Producers 2016

13 July 2016

The updated Guidelines focus on eight key objectives for the petroleum sector in emerging producing countries and include policy-oriented recommendations for each objective.

Dr Valérie Marcel

Associate Fellow, Energy, Environment and Resources Programme

2016-07-13-guidelines-good-governance.jpg

An operating drill during oil and gas exploration. Photo: Getty Images.

Summary

The Guidelines for Good Governance in Emerging Oil and Gas Producers 2016, compiled under the auspices of the New Petroleum Producers Discussion Group, review common challenges facing emerging producer countries in the phases of exploration, recent discoveries and early production. The following are the Guidelines’ broad recommendations for addressing these challenges.

  • International best practice may not be appropriate in the case of emerging producers in the oil and gas sector. Instead, the aim should be for more appropriate practice, taking account of the national context; more effective practice, in the interests of achieving rapid results; and better practice, allowing incremental improvements to governance.
  • Government policy should be guided by a clear vision for the development of the country and a strategic view of how the petroleum sector will deliver that vision. 
  • In order to attract the most qualified oil company to a country with an unproven resource base, the host government can invest in geological data, strengthen its prequalification criteria and ensure transparency. It should also plan for success and anticipate the implications of hydrocarbon discoveries in its tax code, and be robust through declining oil and gas prices.
  • Licensing is a key mechanism whereby government can reap early revenues and maximize long-term national benefits. Government must ensure that it simplifies both negotiations and tax structures to mitigate knowledge asymmetries with oil companies.
  • Government and industry must engage and share information with affected communities to manage local expectations regarding the petroleum sector and build trust. 
  • In emerging producers, budgets for local content may be small and timelines for building capacity short. In this context, the focus should be on the potential for repeat use of any local capacity developed. 
  • Meaningful participation of national organizations in resource development is a central objective of many emerging producers. Capacity is needed to enable this, and the Guidelines examine where and how best to develop that capacity.
  • Incremental improvements to the governance of the national petroleum sector will allow emerging producers to increase accountability. The focus in this regard should be on building up capacity in checks and balances as resources become proven.




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Covid-19: Health needs of sex workers are being sidelined, warn agencies

Agencies have criticised the lack of action to protect the health needs of sex workers during the pandemic, with the English Collective of Prostitutes (ECP) warning of a “ticking time bomb of health...




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Multimodality Imaging of Inflammation and Ventricular Remodeling in Pressure-Overload Heart Failure

Inflammation contributes to ventricular remodeling after myocardial ischemia, but its role in nonischemic heart failure is poorly understood. Local tissue inflammation is difficult to assess serially during pathogenesis. Although 18F-FDG accumulates in inflammatory leukocytes and thus may identify inflammation in the myocardial microenvironment, it remains unclear whether this imaging technique can isolate diffuse leukocytes in pressure-overload heart failure. We aimed to evaluate whether inflammation with 18F-FDG can be serially imaged in the early stages of pressure-overload–induced heart failure and to compare the time course with functional impairment assessed by cardiac MRI. Methods: C57Bl6/N mice underwent transverse aortic constriction (TAC) (n = 22), sham surgery (n = 12), or coronary ligation as an inflammation-positive control (n = 5). MRI assessed ventricular geometry and contractile function at 2 and 8 d after TAC. Immunostaining identified the extent of inflammatory leukocyte infiltration early in pressure overload. 18F-FDG PET scans were acquired at 3 and 7 d after TAC, under ketamine-xylazine anesthesia to suppress cardiomyocyte glucose uptake. Results: Pressure overload evoked rapid left ventricular dilation compared with sham (end-systolic volume, day 2: 40.6 ± 10.2 μL vs. 23.8 ± 1.7 μL, P < 0.001). Contractile function was similarly impaired (ejection fraction, day 2: 40.9% ± 9.7% vs. 59.2% ± 4.4%, P < 0.001). The severity of contractile impairment was proportional to histology-defined myocardial macrophage density on day 8 (r = –0.669, P = 0.010). PET imaging identified significantly higher left ventricular 18F-FDG accumulation in TAC mice than in sham mice on day 3 (10.5 ± 4.1 percentage injected dose [%ID]/g vs. 3.8 ± 0.9 %ID/g, P < 0.001) and on day 7 (7.8 ± 3.7 %ID/g vs. 3.0 ± 0.8 %ID/g, P = 0.006), though the efficiency of cardiomyocyte suppression was variable among TAC mice. The 18F-FDG signal correlated with ejection fraction (r = –0.75, P = 0.01) and ventricular volume (r = 0.75, P < 0.01). Western immunoblotting demonstrated a 60% elevation of myocardial glucose transporter 4 expression in the left ventricle at 8 d after TAC, indicating altered glucose metabolism. Conclusion: TAC induces rapid changes in left ventricular geometry and contractile function, with a parallel modest infiltration of inflammatory macrophages. Metabolic remodeling overshadows inflammatory leukocyte signal using 18F-FDG PET imaging. More selective inflammatory tracers are requisite to identify the diffuse local inflammation in pressure overload.




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Theranostics Targeting Fibroblast Activation Protein in the Tumor Stroma: 64Cu- and 225Ac-Labeled FAPI-04 in Pancreatic Cancer Xenograft Mouse Models

Fibroblast activation protein (FAP), which promotes tumor growth and progression, is overexpressed in cancer-associated fibroblasts of many human epithelial cancers. Because of its low expression in normal organs, FAP is an excellent target for theranostics. In this study, we used radionuclides with relatively long half-lives, 64Cu (half-life, 12.7 h) and 225Ac (half-life, 10 d), to label FAP inhibitors (FAPIs) in mice with human pancreatic cancer xenografts. Methods: Male nude mice (body weight, 22.5 ± 1.2 g) were subcutaneously injected with human pancreatic cancer cells (PANC-1, n = 12; MIA PaCa-2, n = 8). Tumor xenograft mice were investigated after the intravenous injection of 64Cu-FAPI-04 (7.21 ± 0.46 MBq) by dynamic and delayed PET scans (2.5 h after injection). Static scans 1 h after the injection of 68Ga-FAPI-04 (3.6 ± 1.4 MBq) were also acquired for comparisons using the same cohort of mice (n = 8). Immunohistochemical staining was performed to confirm FAP expression in tumor xenografts using an FAP-α-antibody. For radioligand therapy, 225Ac-FAPI-04 (34 kBq) was injected into PANC-1 xenograft mice (n = 6). Tumor size was monitored and compared with that of control mice (n = 6). Results: Dynamic imaging of 64Cu-FAPI-04 showed rapid clearance through the kidneys and slow washout from tumors. Delayed PET imaging of 64Cu-FAPI-04 showed mild uptake in tumors and relatively high uptake in the liver and intestine. Accumulation levels in the tumor or normal organs were significantly higher for 64Cu-FAPI-04 than for 68Ga-FAPI-04, except in the heart, and excretion in the urine was higher for 68Ga-FAPI-04 than for 64Cu-FAPI-04. Immunohistochemical staining revealed abundant FAP expression in the stroma of xenografts. 225Ac-FAPI-04 injection showed significant tumor growth suppression in the PANC-1 xenograft mice, compared with the control mice, without a significant change in body weight. Conclusion: This proof-of-concept study showed that 64Cu-FAPI-04 and 225Ac-FAPI-04 could be used in theranostics for the treatment of FAP-expressing pancreatic cancer. α-therapy targeting FAP in the cancer stroma is effective and will contribute to the development of a new treatment strategy.




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Fibrotic Encapsulation Is the Dominant Source of Continuous Glucose Monitor Delays

Continuous glucose monitor (CGM) readings are delayed relative to blood glucose, and this delay is usually attributed to the latency of interstitial glucose levels. However, CGM-independent data suggest rapid equilibration of interstitial glucose. This study sought to determine the loci of CGM delays. Electrical current was measured directly from CGM electrodes to define sensor kinetics in the absence of smoothing algorithms. CGMs were implanted in mice, and sensor versus blood glucose responses were measured after an intravenous glucose challenge. Dispersion of a fluorescent glucose analog (2-NBDG) into the CGM microenvironment was observed in vivo using intravital microscopy. Tissue deposited on the sensor and nonimplanted subcutaneous adipose tissue was then collected for histological analysis. The time to half-maximum CGM response in vitro was 35 ± 2 s. In vivo, CGMs took 24 ± 7 min to reach maximum current versus 2 ± 1 min to maximum blood glucose (P = 0.0017). 2-NBDG took 21 ± 7 min to reach maximum fluorescence at the sensor versus 6 ± 6 min in adipose tissue (P = 0.0011). Collagen content was closely correlated with 2-NBDG latency (R = 0.96, P = 0.0004). Diffusion of glucose into the tissue deposited on a CGM is substantially delayed relative to interstitial fluid. A CGM that resists fibrous encapsulation would better approximate real-time deviations in blood glucose.




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Prediction models for diagnosis and prognosis of covid-19 infection: systematic review and critical appraisal




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Use of electronic medical records in development and validation of risk prediction models of hospital readmission: systematic review




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Estimated population wide benefits and risks in China of lowering sodium through potassium enriched salt substitution: modelling study




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Use of genetic variation to separate the effects of early and later life adiposity on disease risk: mendelian randomisation study




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Can the New European Commission Deliver on Its Promises to Africa?

4 December 2019

Fergus Kell

Projects Assistant, Africa Programme

Damir Kurtagic

Former Academy Robert Bosch Fellow, Africa Programme
Familiar promises of equal partnership must be backed by bolder action, including an expanded budget, internal reform and a rethink of its approach to trade negotiations.

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Jutta Urpilainen, new EU commissioner for international partnerships, at the European Parliament in Brussels in October. Photo: Getty Images.

The new European Commission, headed by Ursula von der Leyen, assumed office on 1 December, and there are early signs that Africa will begin near the top of their foreign policy priorities. Policy towards Africa under the new EU administration is yet to be fully defined, but its contours are already visible in the selection of commissioners and assignment of portfolios.  

Although rumours of a dedicated commissioner for Africa were unfounded, the appointment of Jutta Urpilainen to the new role of commissioner for international partnerships – replacing the former post of development commissioner – is a strong signal of ongoing change in EU development thinking, away from bilateral aid towards trade and investment, including by the private sector. 

This may have significant consequences for the EU’s relationship with Africa. In her mission letter to Urpilainen in September, von der Leyen listed the first objective as a new ‘comprehensive strategy for Africa’. Urpilainen, Finland’s finance minister before being posted to Ethiopia as special representative on mediation, has also described her appointment as an opportunity to move on from traditional measures of aid delivery. 

Ambition or incoherence? 

However, this ambition may be at odds with other EU priorities and practices, notably managing migration and institutions and instruments for governing EU–Africa relations that remain rooted in a ‘traditional’ model of North–South development cooperation rather than equitable partnership.

Another newly created post will see Margaritis Schinas assume the role of vice-president for promoting the European way of life – formerly ‘protecting our European way of life’ before a backlash saw it changed – a reminder that migration will remain high on the EU’s foreign policy agenda. The new high representative for foreign and security policy and chief EU diplomat, Josep Borrell, has highlighted the need for bilateral partnership with countries of origin and transit, mainly in Africa. 

Negotiations also continue to stall on a replacement to the Cotonou Agreement, the 20-year partnership framework between the EU and the African, Caribbean and Pacific (ACP) group of states, which now looks certain to be extended for at least 12 months beyond its expiry in February 2020.

Ambiguities in the EU’s negotiating approach have certainly contributed to the delay: having pushed initially for a separate regional pillar for Africa that would be opened to the North African countries (who are not ACP members) and include a loosely defined role for the African Union, this would later be abandoned in favour of a dual-track process on separate new agreements with the AU and ACP respectively.

The EU also continues to pursue controversial economic partnership agreements under the aegis of Cotonou, despite their increasing appearance of incompatibility with the pathbreaking African Continental Free Trade Area (AfCFTA) – one of the clearest expressions to date of African agency.

The EU has so far attempted to gloss over this incoherence, claiming that EPAs can somehow act as the ‘building blocks’ for Africa-wide economic integration. But tensions are appearing between EU departments and within the commission, with the European External Action Service inclined to prioritize a more strategic continental relationship with the AU, while the Directorate-General for International Cooperation and Development remains committed to the ACP as the conduit for financial support and aid delivery.

And it is unlikely to get away with such incoherence for much longer. Change is now urgent, as numerous countries in sub-Saharan Africa continue to attract the strategic and commercial interests of the EU’s competitors: from established players such as China and potentially in future the UK, which is intent on remodelling its Africa ties post-Brexit, to emerging actors such as Turkey or Russia, which held its first Africa summit in October. 

The need for delivery

If the EU is serious about its rhetoric on equal partnership, it must therefore move beyond convoluted hybrid proposals. Delivering on the Juncker administration’s proposal to increase funding for external action by 30 per cent for 2021–27 would mark an important first step, particularly as this involves streamlining that would see the European Development Fund – the financial instrument for EU-ACP relations – incorporated into the main EU budget.

The new commission should therefore continue to exert pressure on the European Council and European Parliament to adopt this proposal, as negotiations on this financial framework have been repeatedly subject to delay and may not be resolved before the end of the year. 

Beyond this, proactive support for the AfCFTA and for structural transformation more broadly must be prioritized ahead of vague promises for a continent-to-continent free trade agreement, as held out by Juncker in his final State of the Union address in 2018. 

The significance of internal EU reforms for Africa should also not be discounted. The EU’s Common Agricultural Policy, for instance, has placed the African sector at a particular disadvantage and has made it harder to compete even in domestic markets, let alone in the distant EU export markets. EU efforts to stimulate inflows of private investments into the African agricultural sector, abolish import tariffs and offer technical support for African producers to satisfy EU health and safety regulations will be of little use if they are undermined by heavy subsidies across Europe.

Ultimately, changes to job titles alone will be insufficient. The new commission’s rhetoric, while ambitious, differs little from that of the previous decade – Africa has heard the promise of a ‘partnership of equals’ and of ‘shared ownership’ since before the advent of the Joint Africa–EU Strategy in 2007. Now is the time for truly bold steps to implement this vision.




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Virtual Breakfast: Is a Brexit Delay Possible?

Research Event

7 April 2020 - 8:30am to 9:30am

Event participants

Gavin Barwell, Downing Street Chief of Staff to Prime Minister Theresa May (2017-19)
Chair: Thomas Raines, Director, Europe Programme, Chatham House

Please note this an online-only event.

According to a previously agreed timetable for phase two of Brexit talks, negotiations on the future EU-UK trade relations were scheduled to begin in March. Then a global pandemic hit. Despite the ongoing COVID-19 outbreak, the UK government insists that the Brexit negotiations are on track and there are currently no plans to extend the transition period beyond 2020.

However, the original timetable for trade talks was already widely seen as extremely constrained. Can negotiations still be done in time? With the decision on any possible extension to be made by July at the latest, can the two sides make sufficient progress by that point? Or would the ongoing public health crisis make requesting an extension to the transition period more politically viable for the UK government? Finally, if there is no extension, could Britain still leave the EU with no deal?

In this webinar, the speaker will discuss how the need to manage other challenges, such as the current COVID-19 outbreak, might affect the government’s approach to the negotiations with the EU. He will also share his insights on what to expect from the second phase of negotiations and on the most important lessons from phase one. 

Alina Lyadova

Europe Programme Coordinator




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Delivering Sustainable Food and Land Use Systems: The Role of International Trade

20 September 2019

This paper explores a set of core trade-related issues affecting the food and land use system, and proposes constructive ways forward in reconfiguring the global trading system towards delivering a more sustainable and healthy diet for all.

Bernice Lee OBE

Research Director; Executive Director, Hoffmann Centre for Sustainable Resource Economy

Christophe Bellmann

Associate Fellow, Hoffmann Centre for Sustainable Resource Economy, Chatham House

Jonathan Hepburn

Senior Policy Advisor, International Institute for Sustainable Development

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Aerial view of containers sitting stacked at Qingdao Port in the Shandong province of China. Photo by Han Jiajun/Visual China Group via Getty Images.
  • Meeting future global food security requirements is not just about quantity; it is also about meeting growing needs in a way that safeguards human as well as planetary health. But national priorities and policies often remain out of sync with aspirations for more sustainable and healthy food systems.
  • International trade and trade policies play an ambiguous role in the current food system. With 80 per cent of the world’s population depending on imports to meet at least part of their food and nutritional requirements, trade has a unique function in offsetting imbalances between supply and demand. However, in the absence of effective regulatory frameworks or pricing frameworks that internalize environmental, social or health costs, trade can exacerbate and globalize challenges associated with food production and land use trends such as deforestation, land degradation, greenhouse gas emissions, biodiversity loss and the shift to unhealthy diets.
  • Over the last two decades, trade in agricultural products (excluding intra-EU flows) has more than tripled in value, to reach $1.33 trillion. The geography of global food trade flows has also shifted, primarily towards South–South trade, which now accounts for roughly a quarter of total agricultural trade flows. The nature of global trade has changed drastically, with traditional exports such as wheat and coffee growing slowly at around 2 per cent per year, while products such as palm oil, fruit juice, soft drinks and other processed products have grown at 8 per cent or more annually.
  • This overall increase in trade in agricultural products raises questions about the growing utilization of resources, such as water or soil nutrients, that are embedded in those products through production and processing. Trade itself also causes negative environmental impacts, starting with greenhouse gas emissions associated with transport and storage. If the environmental cost associated with production and trade is not reflected in the final price of goods, trade may accelerate the depletion of resources or their unsustainable use.
  • It is critical to ensure that trade policy options pursued by producing and consuming countries alike will support a transition to more sustainable and healthier food and land use systems. The first step in addressing trade-related food systems challenges must involve rebuilding trust among policy actors. There is a need for new spaces for informal dialogue among actors, and ‘soft’ governance mechanisms that can help rebuild consensus on the best ways forward. Meeting these challenges also requires an appreciation of the complex interactions between sectoral policies (e.g. on water, land, food, etc.) and their multiple interfaces with trade policies. 
  • Conditioning the use of subsidies on their sustainability and/or health impacts encourages the delivery of essential public goods in ways that are consistent with sustainability and health goals. A first step therefore is the removal of perverse incentives (e.g. subsidies encouraging the overuse of fertilizers or pesticides or the overproduction of certain commodities, as well as certain biofuels subsidies) and replacing them with market-correcting subsidies.
  • Trade facilitation measures for fruits and vegetables that are aimed at easing transit at the border, by cutting unnecessary bureaucracy and reducing waiting times, can improve their availability, reduce costs and improve food quality and safety for consumers. Similarly, measures aimed at improving sustainable cold storage and upgrading value chains can support better diets and consumption by increasing the availability of fresh produce on markets, especially in developing countries.
  • A global food stamps programme developed through the G20 and facilitated by the UN’s food agencies could address purchasing power imbalances and tackle malnutrition in developing countries. If carefully designed, such ‘safety net’ schemes can not only contribute to improving calorific intakes but also help deliver more balanced and healthier diets. Careful attention must be given to how such a scheme would work in practice, building on experience to date with similar initiatives.
  • Integrating the notion of sustainable food and inputs trade in the post-2020 global biodiversity framework can help to deliver more sustainable and healthier food and land use systems. This could be achieved by likeminded countries introducing a set of goals or targets aimed at mitigating the role of trade in placing indirect pressure on biodiversity, and to encourage trade in biodiversity-based products including natural ingredients produced ethically and following sustainability principles and criteria.
  • An SDG-oriented agenda for agricultural trade is needed. It could be formed by countries seeking to remove perverse incentives, guaranteeing a safe harbour for market-correcting measures, clarifying existing rules and establishing plurilateral negotiations among subsets of the WTO membership, or sectoral approaches, to address specific challenges.
  • Greenhouse gas emissions resulting from trade need to be addressed. Governments could seek to achieve this through ensuring the carbon neutrality of existing and new trade deals, either by connecting carbon markets among contracting parties or by developing joint initiatives to tax international maritime and air transport emissions.




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Impact of Treating Oral Disease on Preventing Vascular Diseases: A Model-Based Cost-effectiveness Analysis of Periodontal Treatment Among Patients With Type 2 Diabetes

OBJECTIVE

Previous randomized trials found that treating periodontitis improved glycemic control in patients with type 2 diabetes (T2D), thus lowering the risks of developing T2D-related microvascular diseases and cardiovascular disease (CVD). Some payers in the U.S. have started covering nonsurgical periodontal treatment for those with chronic conditions, such as diabetes. We sought to identify the cost-effectiveness of expanding periodontal treatment coverage among patients with T2D.

RESEARCH DESIGN AND METHODS

A cost-effectiveness analysis was conducted to estimate lifetime costs and health gains using a stochastic microsimulation model of oral health conditions, T2D, T2D-related microvascular diseases, and CVD of the U.S. population. Model parameters were obtained from the nationally representative National Health and Nutrition Examination Survey (NHANES) (2009–2014) and randomized trials of periodontal treatment among patients with T2D.

RESULTS

Expanding periodontal treatment coverage among patients with T2D and periodontitis would be expected to avert tooth loss by 34.1% (95% CI –39.9, –26.5) and microvascular diseases by 20.5% (95% CI –31.2, –9.1), 17.7% (95% CI –32.7, –4.7), and 18.4% (95% CI –34.5, –3.5) for nephropathy, neuropathy, and retinopathy, respectively. Providing periodontal treatment to the target population would be cost saving from a health care perspective at a total net savings of $5,904 (95% CI –6,039, –5,769) with an estimated gain of 0.6 quality-adjusted life years per capita (95% CI 0.5, 0.6).

CONCLUSIONS

Providing nonsurgical periodontal treatment to patients with T2D and periodontitis would be expected to significantly reduce tooth loss and T2D-related microvascular diseases via improved glycemic control. Encouraging patients with T2D and poor oral health conditions to receive periodontal treatment would improve health outcomes and still be cost saving or cost-effective.




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Day and Night Home Closed-Loop Insulin Delivery in Adults With Type 1 Diabetes: Three-Center Randomized Crossover Study

Lalantha Leelarathna
Jul 1, 2014; 37:1931-1937
Emerging Technologies and Therapeutics




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Overnight Closed-Loop Insulin Delivery in Young People With Type 1 Diabetes: A Free-Living, Randomized Clinical Trial

Roman Hovorka
May 1, 2014; 37:1204-1211
Advances in Artificial Pancreas Development




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A Mathematical Model for the Determination of Total Area Under Glucose Tolerance and Other Metabolic Curves

Mary M Tai
Feb 1, 1994; 17:152-154
Short Report