ef

Problem Notes for SAS®9 - 65922: Trying to read a Google BigQuery table that contains a variable defined as an array might result in a panic error and SAS shutting down

Trying to read a Google BigQuery table that contains a variable that is defined as an array of records might result in an error and cause SAS to shut down. This issue occurs when one of the variables contained in




ef

Hyperuricemia Predisposes to the Onset of Diabetes via Promoting Pancreatic {beta}-Cell Death in Uricase Deficiency Male Mice

Clinical studies have shown a link between hyperuricemia (HU) and diabetes, while the exact effect of soluble serum urate on glucose metabolism remains elusive. This study aims to characterize the glucose metabolic phenotypes and investigate the underlying molecular mechanisms using a novel spontaneous HU mouse model in which the Uricase (Uox) gene is absent. In an attempt to study the role of HU in glycometabolism, we implemented external stimulation on Uox-knockout (KO) and wild-type (WT) males with a high-fat diet (HFD) and/or injections of multiple low-dose streptozotocin (MLD-STZ) to provoke the potential role of urate. Notably, while Uox-KO mice developed glucose intolerance in the basal condition, no mice spontaneously developed diabetes, even with aging. HFD-fed Uox-KO mice manifested similar insulin sensitivity compared with WT controls. HU augmented the existing glycometabolism abnormality induced by MLD-STZ and eventually led to diabetes, as evidenced by the increased random glucose. Reduced β-cell masses and increased terminal deoxynucleotidyl TUNEL-positive β-cells suggested that HU-mediated diabetes was cell death dependent. However, urate-lowering treatment (ULT) cannot ameliorate the diabetes incidence or reverse β-cell apoptosis with significance. ULT displayed a significant therapeutic effect of HU-crystal– associated kidney injury and tubulointerstitial damage in diabetes. Moreover, we present transcriptomic analysis of isolated islets, using Uox-KO versus WT mice and streptozotocin-induced diabetic WT (STZ-WT) versus diabetic Uox-KO (STZ-KO) mice. Shared differentially expressed genes of HU primacy revealed Stk17β is a possible target gene in HU-related β-cell death. Together, this study suggests that HU accelerates but does not cause diabetes by inhibiting islet β-cell survival.




ef

Transketolase Deficiency in Adipose Tissues Protects Mice From Diet-Induced Obesity by Promoting Lipolysis

Obesity has recently become a prevalent health threat worldwide. Although emerging evidence has suggested a strong link between the pentose phosphate pathway (PPP) and obesity, the role of transketolase (TKT), an enzyme in the non-oxidative branch of the PPP which connects PPP and glycolysis, remains obscure in adipose tissues. In this study, we specifically delete TKT in mouse adipocytes and find no obvious phenotype upon normal diet feeding. However, adipocyte TKT abrogation attenuates high fat diet (HFD)-induced obesity, reduces hepatic steatosis, improves glucose tolerance, alleviates insulin resistance and increases energy expenditure. Mechanistically, TKT deficiency accumulates non-oxidative PPP metabolites, decreases glycolysis and pyruvate input into the mitochondria, leading to increased lipolytic enzyme gene expression and enhanced lipolysis, fatty acid oxidation and mitochondrial respiration. Therefore, our data not only identify a novel role of TKT in regulating lipolysis and obesity, but also suggest limiting glucose-derived carbon into the mitochondria induces lipid catabolism and energy expenditure.




ef

Central KATP Channels Modulate Glucose Effectiveness in Humans and Rodents

Hyperglycemia is a potent regulator of endogenous glucose production (EGP). Loss of this ‘glucose effectiveness’ is a major contributor to elevated plasma glucose concentrations in type 2 diabetes (T2D). ATP-sensitive potassium channels (KATP channels) in the central nervous system (CNS) have been shown to regulate EGP in humans and rodents. We examined the contribution of central KATP channels to glucose effectiveness. Under fixed hormonal conditions (‘pancreatic clamp’ studies), hyperglycemia suppressed EGP by ~50% in both non-diabetic humans and normal Sprague Dawley rats. By contrast, antagonism of KATP channels with glyburide significantly reduced the EGP-lowering effect of hyperglycemia in both humans and rats. Furthermore, the effects of glyburide on EGP and gluconeogenic enzymes in rats were abolished by intracerebroventricular (ICV) administration of the KATP channel agonist diazoxide. These findings indicate that about half of EGP suppression by hyperglycemia is mediated by central KATP channels. These central mechanisms may offer a novel therapeutic target for improving glycemic control in T2D.




ef

Role of VIP and Sonic Hedgehog Signaling Pathways in Mediating Epithelial Wound Healing, Sensory Nerve Regeneration and their Defects in Diabetic Corneas

Diabetic Keratopathy, a sight-threatening corneal disease, comprises several symptomatic conditions including delayed epithelial wound healing, recurrent erosions, and sensory nerve (SN) neuropathy. We investigated the role of neuropeptides in mediating corneal wound healing, including epithelial wound closure and SN regeneration. Denervation by Resiniferatoxin severely impaired corneal wound healing and markedly up-regulated pro-inflammatory gene expression. Exogenous neuropeptides CGRP, SP, and VIP partially reversed Resiniferatoxin’s effects, with VIP specifically inducing IL-10 expression. Hence, we focused on VIP and observed that wounding induced VIP and VIPR1 expression in normal (NL), but not diabetic (DM) mouse corneas. Targeting VIPR1 in NL corneas attenuated corneal wound healing, dampened wound-induced expression of neurotrophic factors, and exacerbated inflammatory responses while exogenous VIP had the opposite effects in DM corneas. Remarkably, wounding and diabetes also affected the expression of Sonic Hedgehog (SHH) in a VIP-dependent manner. Downregulating SHH expression in NL corneas decreased, while exogenous SHH in DM corneas increased the rates of corneal wound healing. Furthermore, inhibition of SHH signaling dampened VIP-promoted corneal wound healing. We conclude that VIP regulates epithelial wound healing, inflammatory response, and nerve regeneration in the corneas in a SHH-dependent manner, suggesting a therapeutic potential for these molecules in treating diabetic keratopathy.




ef

The Effects of B1344, a Novel Fibroblast Growth Factor 21 Analog, on Nonalcoholic Steatohepatitis in Nonhuman Primates

Nonalcoholic steatohepatitis has emerged as a major cause of liver diseases with no effective therapies. Here, we evaluate the efficacies and pharmacokinetics of B1344, a long-acting PEGylated FGF21 analog, in a nongenetically modified nonhuman primate species that underwent liver biopsy, and demonstrate the potential for efficacies in humans. B1344 is sufficient to selectively activate signaling from the βKlotho/FGFR1c receptor complex. In cynomolgus monkeys with nonalcoholic fatty liver disease, administration of B1344 via subcutaneous injection for eleven weeks caused a profound reduction of hepatic steatosis, inflammation and fibrosis, and amelioration of liver injury and hepatocyte death as evidenced by liver biopsy and biochemical analysis. Moreover, improvement of metabolic parameters was observed in the monkey, including reduction of body weight and improvement of lipid profiles and glycemic control. To determine the role of B1344 in the progression of murine NAFLD independent of obesity, administration of B1344 were performed in mice fed with methionine and choline deficiency diet. Consistently, B1344 administration prevented the mice from lipotoxicity damage and nonalcoholic steatohepatitis at a dose-dependent manner. These results provide preclinical validation for an innovative therapeutics to NAFLD, and support further clinical testing of B1344 for treating nonalcoholic steatohepatitis and other metabolic diseases in humans.




ef

Effects of deficiency in the RLBP1-encoded visual cycle protein CRALBP on visual dysfunction in humans and mice [Cell Biology]

Mutations in retinaldehyde-binding protein 1 (RLBP1), encoding the visual cycle protein cellular retinaldehyde-binding protein (CRALBP), cause an autosomal recessive form of retinal degeneration. By binding to 11-cis-retinoid, CRALBP augments the isomerase activity of retinoid isomerohydrolase RPE65 (RPE65) and facilitates 11-cis-retinol oxidation to 11-cis-retinal. CRALBP also maintains the 11-cis configuration and protects against unwanted retinaldehyde activity. Studying a sibling pair that is compound heterozygous for mutations in RLBP1/CRALBP, here we expand the phenotype of affected individuals, elucidate a previously unreported phenotype in RLBP1/CRALBP carriers, and demonstrate consistencies between the affected individuals and Rlbp1/Cralbp−/− mice. In the RLBP1/CRALBP-affected individuals, nonrecordable rod-specific electroretinogram traces were recovered after prolonged dark adaptation. In ultrawide-field fundus images, we observed radially arranged puncta typical of RLBP1/CRALBP-associated disease. Spectral domain-optical coherence tomography (SD-OCT) revealed hyperreflective aberrations within photoreceptor-associated bands. In short-wavelength fundus autofluorescence (SW-AF) images, speckled hyperautofluorescence and mottling indicated macular involvement. In both the affected individuals and their asymptomatic carrier parents, reduced SW-AF intensities, measured as quantitative fundus autofluorescence (qAF), indicated chronic impairment in 11-cis-retinal availability and provided information on mutation severity. Hypertransmission of the SD-OCT signal into the choroid together with decreased near-infrared autofluorescence (NIR-AF) provided evidence for retinal pigment epithelial cell (RPE) involvement. In Rlbp1/Cralbp−/− mice, reduced 11-cis-retinal levels, qAF and NIR-AF intensities, and photoreceptor loss were consistent with the clinical presentation of the affected siblings. These findings indicate that RLBP1 mutations are associated with progressive disease involving RPE atrophy and photoreceptor cell degeneration. In asymptomatic carriers, qAF disclosed previously undetected visual cycle deficiency.




ef

Structures of the MHC-I molecule BF2*1501 disclose the preferred presentation of an H5N1 virus-derived epitope [Protein Structure and Folding]

Lethal infections by strains of the highly-pathogenic avian influenza virus (HPAIV) H5N1 pose serious threats to both the poultry industry and public health worldwide. A lack of confirmed HPAIV epitopes recognized by cytotoxic T lymphocytes (CTLs) has hindered the utilization of CD8+ T-cell–mediated immunity and has precluded the development of effectively diversified epitope-based vaccination approaches. In particular, an HPAIV H5N1 CTL-recognized epitope based on the peptide MHC-I–β2m (pMHC-I) complex has not yet been designed. Here, screening a collection of selected peptides of several HPAIV strains against a specific pathogen-free pMHC-I (pBF2*1501), we identified a highly-conserved HPAIV H5N1 CTL epitope, named HPAIV–PA123–130. We determined the structure of the BF2*1501–PA123–130 complex at 2.1 Å resolution to elucidate the molecular mechanisms of a preferential presentation of the highly-conserved PA123–130 epitope in the chicken B15 lineage. Conformational characteristics of the PA123–130 epitope with a protruding Tyr-7 residue indicated that this epitope has great potential to be recognized by specific TCRs. Moreover, significantly increased numbers of CD8+ T cells specific for the HPAIV–PA123–130 epitope in peptide-immunized chickens indicated that a repertoire of CD8+ T cells can specifically respond to this epitope. We anticipate that the identification and structural characterization of the PA123–130 epitope reported here could enable further studies of CTL immunity against HPAIV H5N1. Such studies may aid in the development of vaccine development strategies using well-conserved internal viral antigens in chickens.




ef

A Legionella effector kinase is activated by host inositol hexakisphosphate [Enzymology]

The transfer of a phosphate from ATP to a protein substrate, a modification known as protein phosphorylation, is catalyzed by protein kinases. Protein kinases play a crucial role in virtually every cellular activity. Recent studies of atypical protein kinases have highlighted the structural similarity of the kinase superfamily despite notable differences in primary amino acid sequence. Here, using a bioinformatics screen, we searched for putative protein kinases in the intracellular bacterial pathogen Legionella pneumophila and identified the type 4 secretion system effector Lpg2603 as a remote member of the protein kinase superfamily. Employing an array of biochemical and structural biology approaches, including in vitro kinase assays and isothermal titration calorimetry, we show that Lpg2603 is an active protein kinase with several atypical structural features. Importantly, we found that the eukaryote-specific host signaling molecule inositol hexakisphosphate (IP6) is required for Lpg2603 kinase activity. Crystal structures of Lpg2603 in the apo-form and when bound to IP6 revealed an active-site rearrangement that allows for ATP binding and catalysis. Our results on the structure and activity of Lpg2603 reveal a unique mode of regulation of a protein kinase, provide the first example of a bacterial kinase that requires IP6 for its activation, and may aid future work on the function of this effector during Legionella pathogenesis.




ef

Effect of a Sustained Reduction in Plasma Free Fatty Acid Concentration on Intramuscular Long-Chain Fatty Acyl-CoAs and Insulin Action in Type 2 Diabetic Patients

Mandeep Bajaj
Nov 1, 2005; 54:3148-3153
Metabolism




ef

AMPK: A Target for Drugs and Natural Products With Effects on Both Diabetes and Cancer

D. Grahame Hardie
Jul 1, 2013; 62:2164-2172
Perspectives in Diabetes




ef

PPARA Polymorphism Influences the Cardiovascular Benefit of Fenofibrate in Type 2 Diabetes: Findings From ACCORD-Lipid

Mario Luca Morieri
Apr 1, 2020; 69:771-783
Genetics/Genomes/Proteomics/Metabolomics




ef

Intense Exercise Has Unique Effects on Both Insulin Release and Its Roles in Glucoregulation: Implications for Diabetes

Errol B. Marliss
Feb 1, 2002; 51:S271-S283
Section 6: Pusatile and Phasic Insulin Release in Normal and Diabetic Men




ef

Effect of a High-Protein, Low-Carbohydrate Diet on Blood Glucose Control in People With Type 2 Diabetes

Mary C. Gannon
Sep 1, 2004; 53:2375-2382
Pathophysiology




ef

Latent Autoimmune Diabetes in Adults: Definition, Prevalence, {beta}-Cell Function, and Treatment

Gunnar Stenström
Dec 1, 2005; 54:S68-S72
Section II: Type 1-Related Forms of Diabetes




ef

Re: The positive effects of covid-19




ef

Re: Mitigating the wider health effects of covid-19 pandemic response




ef

Benefits of face masks and social distancing in Tuberculosis - a lesson learnt the hard way during the COVID-19 pandemic.




ef

The war on drugs has failed: doctors should lead calls for drug policy reform




ef

Risks of duloxetine for stress incontinence outweigh benefits, say researchers




ef

Plaintiff in Chief: President Trump and the American Legal System

Members Event

30 October 2019 - 1:00pm to 2:00pm

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

Event participants

James D Zirin, Host, Conversations with Jim Zirin; Author, Plaintiff in Chief: A Portrait of Donald Trump in 3500 Lawsuits

Chair: Chanu Peiris, Programme Manager, International Law Programme, Chatham House

Since assuming office, President Donald Trump’s many encounters with litigation have exposed significant irregularities of the American legal system as it applies to the president.

These encounters – including but not limited to accusations of defamation, obstruction, perjury and non-disclosure agreements – have shown President Trump to hold a particular interpretation of how the rule of law should apply to someone holding the highest elected office in the United States of America.

However, an analysis of Trump’s legal history prior to his assumption of office reveals a tried and tested method of using litigation – or the threat of it – to quieten criticism and opponents. As Trump faces possible impeachment in the House of Representatives, what – if any – influence might his combative approach towards legal battles have on the political proceedings?

Drawing on New York attorney James Zirin’s new book, Plaintiff in Chief, this event examines the relationship between President Trump’s litigation history and his approach to the presidency.

How has the American legal system facilitated Trump’s attitude towards litigation? How can his litigation toolkit be countered?

And what impact has the president’s approach to litigation had on the domestic and global reputation of the American legal system and the office of the president as accountable and credible institutions?

 

Members Events Team




ef

Reflections from the Munich Security Conference on America’s Role in the World

Invitation Only Research Event

17 February 2020 - 8:00am to 9:15am

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

Event participants

Senator Chris Coons, United States Senator, Delaware
Chair: Dr Leslie Vinjamuri, Director, US and Americas Programme

In the aftermath of World War II, the United States cemented its role as the leader of a new global order, characterized by the creation of international institutions and treaties like the United Nations and North Atlantic Treaty Organization. More recently, however, the United States has appeared to take an inward turn, a trend which has been mirrored across the globe and has led to the international order being challenged more now than ever before.

As the Trump administration and US members of Congress attempt to address multiple challenges from a rising China and a disruptive Russia to a nuclear North Korea and shifting Middle East, Senator Chris Coons will offer his vision for restoring American leadership on the world stage.What is the role of Congress in setting and shaping US foreign policy?  How will the outcome of the consequential 2020 elections shape the future of America’s global role? Would a change in administration necessarily increase prospects of American reengagement, and if so, across which international spheres?

Event attributes

Chatham House Rule

Department/project

US and Americas Programme




ef

A Transatlantic Partnership for WTO Reform in the Age of Coronavirus

Webinar Research Event

28 April 2020 - 2:00pm to 3:00pm

Event participants

Ignacio Garcia Bercero, Director, Directorate General for Trade of the European Commission; European Union Visiting Fellow, Oxford University
Jennifer Hillman, Senior Fellow for Trade and International Political Economy, Council on Foreign Relations; Member, WTO Appellate Body, 2007 - 11
Chair: Marianne Schneider-Petsinger, Senior Research Fellow, US and Americas Programme, Chatham House

Global trade and the WTO – which has been at the heart of the rules-based international trade system since its creation in 1995 – faced a critical moment even before COVID-19. The Appellate Body’s demise in December 2019 led to a renewed focus on the future of the WTO. But the challenges facing the WTO run deeper than that – the organization has lost relevance as a negotiation forum, resulting in the global trade rules not having kept pace with changes in technology and the rise of China. While the WTO provides a forum for international cooperation to address the trade fallout from COVID-19, what implications will the pandemic have for the long-term reform of the global trade system?

Both the US and EU have proposed various WTO reform strategies and taken steps towards collaboration, but is a transatlantic partnership for WTO reform feasible? Do the US and EU believe that a rules-based international trade system is in their interest – especially in light of COVID-19? What are the biggest issues dividing the US and EU on reforming the WTO, and is there a common assessment of the key problems? What steps can the US and EU take to address the dispute settlement function of the WTO and to modernize the trade rules? Are there broader issues, such as environmental and social sustainability, that should be included in a transatlantic agenda for WTO reform?

This event is  part of the Chatham House Global Trade Policy Forum and will take place virtually only.

We would like to take this opportunity to thank founding partner AIG and supporting partners Clifford Chance LLP, Diageo plc, and EY for their generous support of the Chatham House Global Trade Policy Forum.




ef

Covid-19: Lack of capacity led to halting of community testing in March, admits deputy chief medical officer




ef

Some 25 charities, organisations to benefit from AFJ grant

The Open Arms Development Centre, a homeless shelter in downtown Kingston, and Jamaica’s COVID-19 Response Fund Food Relief are among 25 charitable and community organisations across the island to benefit from the latest round of grants from US-...




ef

Ukraine’s Reform Agenda: Shaping the Future

Members Event

21 November 2019 - 7:00pm to 8:00pm

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

Event participants

Oleksiy Honcharuk, Prime Minister, Ukraine

Chair: Robert Brinkley, Chairman, Steering Committee, Ukraine Forum, Chatham House

In 2019, Ukraine underwent another revolution five years since the previous one – this time through the ballot box. Volodymyr Zelenskyy and his party, Servant of the People, won an overwhelming majority giving them a large mandate for change, especially for economic growth and anti-corruption reform.

Looking beyond electoral promises, Ukraine’s prime minister, Oleksiy Honcharuk, presents the plans and vision of the new government.

What are the key priorities of the new Cabinet? How will they go about delivering on the structural reforms that underpin economic growth, not least strengthening the rule of law? What is the path to steady economic growth? What are the internal and external risks en route and how can the West best assist in Ukraine’s reform agenda?

Department/project

Members Events Team




ef

Political Will Was Not Enough for Justice Reform in Moldova

27 November 2019

Cristina Gherasimov

Former Academy Associate, Russia and Eurasia Programme
The pro-reform Sandu government had the will to dismantle oligarchic power structures, but was taken down by limited political experience.

2019-11-26-Sandu.jpg

Maia Sandu in Germany in July. Photo: Getty Images.

The lack of political will to carry out rule of law reforms is frequently the reason why reforms are not fully implemented. The case of Moldova proves that in societies where strong vested interests still persist, political savviness is equally as important as political will.

Old and new political power brokers in Moldova struck a fragile pact in June to oust Vladimir Plahotniuc. Plahotniuc had built a network of corruption and patronage with the help of the Democratic Party, which he treated as a personal vehicle and which allowed him and a small economic elite circle to enrich themselves off of government institutions and state-owned enterprises, to the detriment of Moldovan citizens and the health of their political process.

Maia Sandu, co-leader of the pro-reform ACUM electoral bloc, then formed a technocratic government with a remit to implement Moldova’s lagging reform agenda. Though made up of ministers with the integrity and political will to implement difficult transformational reforms, its biggest weakness was its coalition partner – the pro-Russian Socialists’ Party and its informal leader, Igor Dodon, the president of Moldova.

Now the Socialists – threatened by how key reforms to the justice system would impact their interests – have joined forces with Plahotniuc’s former allies, the Democratic Party, to oust ACUM, exploiting the party’s lack of political savviness. 

Reform interrupted

It was always clear the coalition would be short-lived. President Dodon and the co-ruling Socialists joined to buy themselves time, with the hope that they could restrict the most far-reaching reforms and tie the hands of ACUM ministers. In less than five months, however, the Sandu government initiated key reforms in the judicial system, aimed at dismantling Plahotniuc’s networks of patronage but also impacting the Socialists, who to a large degree also profited from the previous status quo.

The red line came over a last-minute change in the selection process of the prosecutor general proposed by Sandu on 6 November, which the Socialists claimed was unconstitutional and gave them the justification to put forward a motion of no confidence in the Sandu government. This was conveniently supported by the Democratic Party, who appeared threatened by an independent prosecutor’s office and saw an opportunity to return to power.

Thus, the political will to reform proved insufficient in the absence of a clear strategy on how to address the concerns of the old regime that they would be prosecuted and their vested interests threatened. Here, ACUM’s lack of political experience let them down. With their hands tied from the beginning in a fragile coalition with the Socialists, ACUM were unable to prevent sabotage from within state institutions and their own coalition, and could not find consensus to proceed with more radical methods to tackle corruption.

Less than two days after the Sandu government was out, a new government was sworn in on 14 November. Prime Minister Ion Chicu was an adviser to President Dodon before taking office and former minister of finance under the Plahotniuc-backed government of Pavel Filip, as part of a cabinet of ministers consisting largely of other presidential advisers and former high-level bureaucrats and ministers from the Plahotniuc era. 

The new government

A top priority for the Chicu government is to convince the international community that it is independent from President Dodon, and that its ‘technocrats’ will keep the course of reforms of the Sandu government. This is critical to preserving the financial assistance of Western partners, which the Moldovan government heavily relies on, particularly with a presidential election campaign next year, when they will likely want to create fiscal space for various giveaways to voters.

But within its first week in office, Chicu appears incapable of walking this line. Reverting to the initially proposed pre-selection process of prosecutor general signals that the post could be filled by a loyal appointee of President Dodon. Moreover, Chicu’s first visit abroad was to Russia, allegedly a major financial contributor of the Socialists’ Party. With the Socialists now holding the presidency, government, Chisinau mayoralty, and the parliament speaker’s seat, the danger of an increased Russian influence on key political decisions is very real.

A government steered by President Dodon risks bringing Moldova back to where it was before June, with a political elite mimicking reforms while misusing power for private gains. The biggest danger is that instead of continuing the reform process to bring Moldova back on its European integration path, the new government may focus on strengthening the old patronage system, this time with President Dodon at the top of the pyramid.

Lessons

This new minority government, supported by the Democrats, is a more natural one for President Dodon and therefore has more chances to survive, at least until presidential elections in autumn of 2020. Both the Socialists and the Democrats will likely seek to use this time to rebuild their own methods of capturing state resources. But with the Socialists relying on the Democrats’ votes in parliament, this is a recipe for further political instability.

Similar to Moldova, several other states across the post-Soviet space such as Ukraine and Armenia have had new political forces come to power with the political will and mandate to carry out difficult reforms to strengthen rule of law and fight systemic corruption in their countries. What they all have in common is the lack of political experience of how to create change, while old elites, used to thinking on their feet to defend their vested interests, retain their connections and economic and political influence.

Moldova is a good example of why political will needs to be backed up by clear strategy on how to deal with threatened vested interests in order for new political forces to be able to maintain themselves in power and reforms to be sustainable. When the chance comes again for fresh leaders to come to power, it is importantthey are politically prepared to use it swiftly and wisely.




ef

Belarusians Left Facing COVID-19 Alone

16 April 2020

Ryhor Astapenia

Robert Bosch Stiftung Academy Fellow, Russia and Eurasia Programme

Anaïs Marin

Associate Fellow, Russia and Eurasia Programme
The way the epidemic is being mismanaged creates a risk of political destabilisation and leaves the country exposed to external influence.

2020-04-16-Belarus-COVID-Football

Playing accordion in front of dummy football fans in Brest, Belarus as the country's championship continues despite the COVID-19 outbreak. Photo by SERGEI GAPON/AFP via Getty Images.

Since the World Health Organisation (WHO) declared COVID-19 a pandemic, few countries have chosen to ignore social distancing recommendations. But, even among those states which have, the Belarusian official response to its epidemic remains unique.

President Aliaksandr Lukashenka’s statements that vodka, sauna and tractors are protecting Belarusians from coronavirus attracted amused attention in international media. Lukashenka also described other societies’ response to COVID-19 as ‘a massive psychosis’.

Although Lukashenka is notorious for his awkward style of public communication, the fact that Belarus is refusing to impose comprehensive confinement measures is of concern. Belarusians continue to work, play football and socialise.

Lukashenka, himself playing ice hockey in front of state cameras, claims it is the best way to stay healthy. Belarusian authorities clearly appear to be in denial – and this could have dire humanitarian consequences.

From denial to half measures

Belarus actually has one of the largest numbers of hospital beds in the world per 1,000 of the population. But in the absence of quarantine measures its health system, already crippled by corruption and embezzlement, is likely to be overwhelmed.

Patients being treated for pneumonia in hospitals have suggested medical staff are uninformed and inadequately equipped. It is claimed doctors are not reporting COVID-19 as the suspected cause of death, either through a lack of testing or for fear of reprisals.

Observers believe the real mortality rate is already well above official figures (40 deaths as of 16 April). Based on an Imperial College London model, between 15,000 and 32,000 people could die under the current mild confinement regime – and such a high death toll would hugely impact the country’s political stability. Citing personal data protection, the Ministry of Health has imposed a total news blackout; the only cluster officially acknowledged so far is the city of Vitsebsk.

Although specific Belarusian cities and some individuals started changing their approach – by extending school vacations or cancelling weddings – such measures remain half-hearted.

Clearly a major reason for such an apparently irresponsible reaction is that Belarus cannot afford a massive lockdown that would freeze its already underdeveloped economy and drive it deeper into recession. Unlike many other nations, Belarus lacks budgetary resources for a sizable stimulus package. But a delayed response might backfire on the economy.

Economic recession has been forecast to amount to at least 10% of GDP. For Lukashenka, who openly challenged conventional wisdom regarding the need for quarantine and isolation, such an economic downturn would harm his confidence rating in the eyes of Belarusian voters, mindful of the state’s mismanagement of the crisis. And it could create doubt within the ruling elite itself, with Lukashenka seeking re-election for a sixth mandate in late August.

Against this backdrop, a radicalization of the opposition-minded part of society is also to be expected, with greater reliance on social networks in the face of official secrecy and disinformation. The expected response of the regime is then likely to be pre-emptive repression. Evidence is emerging that law enforcement agencies have already stepped up judicial and paralegal harassment of dissenters, notably independent journalists and bloggers.

Russia’s initial reluctance to address the coronavirus crisis may also have influenced Belarus. Lukashenka and his administration often react to public health challenges by the Soviet rulebook, reminiscent of the Soviet authorities’ mismanagement of the Chernobyl disaster in 1986.

Russia has unilaterally closed its borders with Belarus and, as bilateral relations continue to deteriorate, this casts further doubt on the viability of the Union State of Belarus and Russia. Pro-Russian media forecast Moscow will be unwilling to alleviate the expected socio-economic crisis, as it continues to reject Minsk’s demands regarding subsidised oil deliveries. Yet the Kremlin might use the crisis as an opportunity to resume its integrationist pressure on Belarus.

China, with which Belarus engaged in a seemingly privileged strategic partnership in the 2010s, was actually the first country to dispatch humanitarian aid to beef up Belarusian capacity to fight the virus.

But Minsk should not expect Beijing to rescue its economy and, unless it commits to more internal reforms, Belarus is not likely to receive much from the EU either. The regime has already applied to the IMF for emergency financial support, but conditions are attached and, even if successful, the funds would amount to no more than $900m.

The government’s decision to take only half measures so far is rooted in the hope COVID-19 is not as bad as foreign experts fear. But, unless the leadership acknowledges the public health crisis and mitigates its economic impact, COVID-19 will accelerate Belarus’s slide back into international self-isolation. If combined with a humanitarian crisis, this will put the Belarusian regime under considerable stress.

This crisis does risk a new ‘Chernobyl moment’ for the authorities, but the population could react more vocally this time. As volunteers self-organise to fight the epidemic, it might become more difficult for the authorities to say that it is efficient in running the country. But the bottom line is Belarus desperately needs money. Whoever steps up to support Belarus financially will also be able to heavily influence its politics.




ef

Virtual Roundtable: Land Reform in Ukraine: Is Zelenskyy's Government Getting it Right?

Invitation Only Research Event

14 May 2020 - 12:00pm to 1:30pm
Add to Calendar
Ihor Petrashko, Minister of Economic Development and Trade, Ukraine
Andriy Dykun, Chair, Ukrainian Agricultural Council
Vadim Tolpeco, Ukrlandfarming Plc
Chair: Orysia Lutsevych, Research Fellow and Manager, Ukraine Forum, Chatham House
Ukraine is known as the ‘breadbasket of Europe’ thanks to its grain exports. On 31 March 2020, the Ukrainian parliament passed a landmark law ending a 19-year ban on the sale of privately owned agricultural land. Due to come into force in July 2021, the law applies to 41.5 million hectares of farmland and economists predict substantial economic gains from this liberalization.
 
This event will discuss the impact of the law on Ukraine’s agricultural sector and food security. How can the government best implement this reform and ensure that small and medium-sized agricultural companies increase their productivity? What does this change mean for Ukraine’s capacity to export grain? Can the country’s food supply withstand crises such as the COVID-19 pandemic? What role could foreign direct investors play in boosting production?
 
This event will be held on the record.

Anna Morgan

Administrator, Ukraine Forum
+44 (0)20 7389 3274




ef

Careful as you go

A time will come, When you don’t even, Own your own body, On the side of the road, A full breakdown not a common, Puncture, Leave your heart, it’s broken, Total mechanical failure. What will you do? Trust what you have given? Love, a blue opinion? You have only what you spent. You think you […]




ef

Refugees

If we are to be Gods we must, Musk, Be life forms using noses and spectrograms, Be blue animals, Hurtling through space, dentists Doxologists, Cobblers mending hard drives, Therapists, Slippers, Saving the world, Changing the climate, Becoming responsible politicians, Setting safe harbour as we go. -short evocative poetry-




ef

Pain relief

​ Builders will continue to build, and White folk dumpster dive,  In the winter anyway, In red, And blue overalls, scavenge – Scavenger, Some for profit, others fun, and I Cannot be a predator, I Cannot carry luggage, I Am dying, and Perhaps giving things away, a book or something will relive the pain, lord […]




ef

Refugee

Smelly in the corner, On a black, Leather sofa, We speak he and I with oiled bodies, we Recline at will, With silver-lined laptops, With morning beer in, Plastic cups, ice-cream Tins, we Touch minds gently across thrusting porn-stars, He and I, and we We will make it happen, Perhaps, Emigrate, Fiddle with love beyond […]




ef

Said the Joker to the Thief

  Don’t make fun of the flower arranger, Ikebana Is self – discipline, a Nip here, a Snip there, and With fullness of time, and Passage through life, Done with the flash of a scissor, Bone handles, Glinting, Scissor flash snip, all gone Extra weight, things un-needed, flash Unheeded, If you stop, To think about, […]




ef

A Global Response to HFCs through Fair and Effective Ozone and Climate Policies

11 July 2014

Rising HFC use poses a significant threat to intergovernmental efforts to combat climate change. At present, there is a glaring regulatory gap in this area. Although challenging, there is no reason why the international community cannot come together to address this new problem of coordination and ensure that legal regimes support each other.

Duncan Brack

Associate Fellow, Energy, Environment and Resources Programme

Stephen O. Andersen

Director of Research, the Institute for Governance & Sustainable Development (IGSD)

Joanna Depledge

Affiliated Lecturer, Department of Politics and International Studies, University of Cambridge

20140710GlacierHFCClimate.jpg

In this aerial image, icebergs are seen as a glacier is flown into the sea on July 30, 2012 near Qaanaaq, Greenland. Photo by The Asahi Shimbun via Getty Images.

Hydrofluorocarbons (HFCs) are replacements for many of the chlorofluorocarbons (CFCs) and hydrochlorofluorocarbons (HCFCs) currently being phased out under the Montreal Protocol on Substances that Deplete the Ozone Layer. Unlike those ozone-depleting substances (ODS), HFCs do not destroy the ozone layer, but they are very powerful greenhouse gases (GHGs) – up to thousands of times more damaging to the climate than carbon dioxide – and their use is currently growing faster than any other category of GHGs. Projections show HFC use increasing as much as 30-fold by 2050, adding up to 0.1°C of global average temperature rise by mid-century, and increasing up to five-fold, to 0.5°C, by 2100. This clearly makes it more difficult to limit the rise in global temperature to the internationally agreed ceiling of 2°C – and thereby avoid dangerous climate change – by the end of the 21st century.

As GHGs, HFCs fall under the purview of the 1992 United Nations Framework Convention on Climate Change (UNFCCC) and are explicitly listed under the UNFCCC’s 1997 Kyoto Protocol, which controls emissions of HFCs and other GHGs. They are not, however, subject to any specific measures under the climate agreements, and this is unlikely to change in the near future. Accordingly, the last five years have seen proposals to amend the Montreal Protocol to phase down the production and consumption of HFCs.

Such a step would have a number of advantages. Since substitutes already exist for almost all uses of HFCs, the consumption and production phase-out model of the Montreal Protocol is better suited to controlling HFCs than the emissions limits controls of the climate regime; and the individuals and organizations involved in implementing the Montreal Protocol have accumulated substantial experience and expertise in dealing with precisely those industrial sectors in which HFCs are used, including refrigeration and air-conditioning, foams, solvents and aerosols.

This paper, which draws on the discussions at a workshop held at Chatham House in April 2014, outlines the main issues around the question of how best to craft a fair and effective global response to the growth in HFC use. A number of key issues are central to the debate: the principle of equity between developed and developing countries; the availability of alternatives to HFCs; the need for financial support for developing countries; the legal relationship between the climate and ozone regimes; and, underlying all these, the need for political will to resolve these challenges.




ef

Mark Wignall | Some will be left out!

A recent Washington Post article reminds us of this frightening statistic: the first 100,000 cases of COVID-19 occupied all of three months to reach that milestone. It also stated that the second 100,000 cases sprinted to that number in 12 days....




ef

Insulin-Deficient Diabetic Condition Upregulates the Insulin-Secreting Capacity of Human Induced Pluripotent Stem Cell-Derived Pancreatic Endocrine Progenitor Cells After Implantation in Mice

The host environment is a crucial factor for considering the transplant of stem cell–derived immature pancreatic cells in patients with type 1 diabetes. Here, we investigated the effect of insulin (INS)-deficient diabetes on the fate of immature pancreatic endocrine cell grafts and the underlying mechanisms. Human induced pluripotent stem cell–derived pancreatic endocrine progenitor cells (EPCs), which contained a high proportion of chromogranin A+ NK6 homeobox 1+ cells and very few INS+ cells, were used. When the EPCs were implanted under the kidney capsule in immunodeficient mice, INS-deficient diabetes accelerated increase in plasma human C-peptide, a marker of graft-derived INS secretion. The acceleration was suppressed by INS infusion but not affected by partial attenuation of hyperglycemia by dapagliflozin, an INS-independent glucose-lowering agent. Immunohistochemical analyses indicated that the grafts from diabetic mice contained more endocrine cells including proliferative INS-producing cells compared with that from nondiabetic mice, despite no difference in whole graft mass between the two groups. These data suggest that INS-deficient diabetes upregulates the INS-secreting capacity of EPC grafts by increasing the number of endocrine cells including INS-producing cells without changing the graft mass. These findings provide useful insights into postoperative diabetic care for cell therapy using stem cell–derived pancreatic cells.




ef

After grief and injury, Gohara sets the bar high

Having seen what Luiz Gohara had done upon his introduction to the big leagues the previous September, Freddie Freeman told Alex Anthopoulos the big left-hander might immediately became an All-Star. Instead, it became a year of awakening for the young hurler, who remains fueled by last year's disappointments.




ef

Back in rotation, McHugh able to draw on relief

With Dallas Keuchel and Charlie Morton leaving in free agency and Lance McCullers Jr. on the mend following Tommy John surgery, Collin McHugh is returning to his roots this year and is back in the Houston rotation. He said his experience as a reliever will only help him evolve as a starter.




ef

US pulls permission for Chinese masks found defective

WASHINGTON (AP) — Federal health officials have revoked US authorisation for masks made by more than 60 Chinese manufacturers after they failed to meet standards needed to protect health care workers. The Food and Drug Administration had...




ef

Cash for referrals

Private hospital chains have been “buying” referrals by offering clinicians lucrative packages, including free facilities in sought after locations. And the doctors’ regulator is turning a blind eye to those who are tempted, Reporter Jonathan Gornall joins us to discuss the investigation. Read the full...




ef

They drained 92L from me - diagnosis and management of pleural effusion

Pleural effusions are common, with an estimated 1-1.5 million new cases in the United States and 200 000-250 000 in the United Kingdom each year. Rahul Bhatnagar, academic clinical lecturer at the University of Bristol, describes how pleural effusions may be investigated and treated in the community and secondary care, with a particular focus on...




ef

The Weekend Effect - what's (un)knowable, and what next?

We do we know about the weekend effect? As Martin McKee puts it in an editorial on thebmj.com, "almost nothing is clear in this tangled tale" In this roundtable, Navjoyt Ladher, Analysis editor for The BMJ is joined by some of the key academics who have published research and commented on the weekend effect to make sense of what we know and...




ef

Late effects of anticancer chemotherapy: It's hard to trust your body, after it's betrayed you

Lily was diagnosed at 14 years old with stage four Hodgkin's lymphoma and received six rounds of chemotherapy and two weeks of radiotherapy. She survived but now lives with the long term effects of that therapy - and joins us to discuss how it has impacted her quality of life. We're also joined by Saif Ahmad and Thankamma Ajithkumar, oncologists...




ef

Helping patients with complex grief

Each individual’s grief process is unique, when confronted with the death of a loved one, most people experience transient rather than persistent distress - however 10% of bereaved individuals, with an increased risk following the death of a partner or child and loss to unnatural or violent circumstances, experience prolonged grief disorder. In...




ef

Nigel Crisp - The NHS isn't just a cost to society, it's a benefit

If you google "The NHS" you'll see screaming headlines from the Daily Mail about cost and waste - debate in parliament is about how much of our GDP we should be spending - and each year, hospital trusts go cap in hand to ask for more funding. Against this backdrop, a new analysis, and a first in a series, published on bmj.com, looks at what it...




ef

Defending evidence informed policy making from ideological attack

If you’re of a scientific persuasion, watching policy debates around Brexit, or climate change, or drug prohibition are likely to cause feelings of intense frustration about the dearth of evidence in those discussions. In this podcast we're joined by Chris Bonell, professor of public health sociology - in this podcast he airs those frustrations,...




ef

The counter intuitive effect of open label placebo

Ted Kaptchuk, professor of medicine at Harvard Medical school - and leading placebo researcher, has just published an analysis on bmj.com describing the effect of open label placebo - placebos that patient's know are placebos, but still seem to have some clinical effect. Ted joins us to speculate about what's going on in the body, what this means...




ef

Talk evidence - cancer causing food, prostate cancer and disease definitions

Helen Macdonald and Carl Heneghan are back again talking about what's happened in the world of evidence this month. (1.05) Carl rants about bacon causing cancer (7.10) Helen talks about prostate cancer, and we hear from the author of the research paper which won Research Paper Of The Year at the BMJ awards. We also cover disease definition and...




ef

Cycling - Does the health benefit outweigh the accident risk (in the UK)

We all know we should be doing more exercise, and one way to do that is by active commuting - journeying to work on foot or by bike. One thing preventing people from taking up cycling is the fear of being involved in road traffic accidents, and that the risk isn't worth the benefit of the extra exercise. It’s even more confusing when air...