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Background Patients presenting with acute interstitial nephritis (AIN) of unknown aetiology, probably the earliest presentation of chronic kidney disease of unknown aetiology (CKDu), have been treated with oral prednisolone and doxycycline by physicians in Sri Lanka. This trial assessed the effectiveness of prednisolone and doxycycline based on eGFR changes at 6 months in patients with AIN of unknown aetiology. Method A randomized clinical trial with a 2 × 2 factorial design for patients presenting with AIN of unknown aetiology (n = 59) was enacted to compare treatments with; A-prednisolone, B-doxycycline, C-both treatments together, and D-neither. The primary outcome was a recovery of patients’ presenting renal function to eGFR categories: 61–90 ml/min/1.73m2 (complete remission– CR) to 31–60 ml/min/1.73m2 (partial remission– PR) and 0–30 ml/min/1.73m2 no remission (NR) by 6 months. A secondary outcome was progression-free survival (not reaching 2 eGFR), by 6–36 months. Analysis was by intention to treat. Results Seventy patients compatible with a clinical diagnosis of AIN were biopsied for eligibility; 59 AIN of unknown aetiology were enrolled, A = 15, B = 15, C = 14 and D = 15 randomly allocated to each group. Baseline characteristics were similar between groups. The number of patients with CR, PR and NR, respectively, by 6 months, in group A 3:8:2, group B 2:8:3 and group C 8:5:0 was compared with group D 8:6:1. There were no significant differences found between groups A vs. D (p = 0.2), B vs. D (p = 0.1) and C vs. D (p = 0.4). In an exploratory analysis, progression-free survival in prednisolone-treated (A + C) arms was 0/29 (100%) in comparison to 25/30 (83%) in those not so treated (B + D) arms, and the log-rank test was p = 0.02, whereas no such difference found (p = 0.60) between doxycycline-treated (B + C) arms 27/29 (93%) vs those not so treated (A + D) arms 27/30 (90%). Conclusion Prednisolone and doxycycline were not beneficial for the earliest presentation of CKDu at 6 months. However, there is a potential benefit of prednisolone on the long-term outcome of CKDu. An adequately powered steroid trial using patients reaching 2 eGFR by 3 years, as an outcome is warranted for AIN of unknown aetiology. Trial registration Sri Lanka Clinical Trial Registry SLCTR/2014/007, Registered on the 31st of March 2014.

International climate finance plays a key role in enabling the implementation of adaptation measures. However, while there is a common metric for gauging the effectiveness of finance for mitigation – greenhouse gas emission reduction per unit of funding – no corresponding metric exists for adaptation. Instead, assessments of what works best in adaptation finance focus either on procedural aspects of funding modalities, such as equity in the allocation of funding, or on the extent to which specific adaptation activities produce the desired results. This mixed methods systematic review aims to assess the effectiveness of adaptation finance and bridge the gap between those two approaches. It involves a transparent and comprehensive synthesis of the academic and grey literature on how different characteristics of adaptation projects in sub-Saharan Africa – and finance for those projects – affect adaptation outcomes, particularly in terms of risk and vulnerability to climate change impacts. Finalised adaptation projects funded by a set of the multilateral climate funds and two bilateral donors (United Kingdom and Sweden) are the focus of this review. The findings can help inform the future design and implementation of adaptation activities as well as funding decisions.

Groundwater is a critical resource for supporting human consumption, stock water, agricultural use, and mineral or energy extraction as well as the environment. However, the quality of groundwater varies enormously from potable to hyper-saline, particularly in the Australian context. To evaluate the suitability of a groundwater resource, the spatial distribution of salinity within an aquifer is typically estimated by measuring the electrical conductivity (EC) of groundwater sampled from boreholes. However, drilling is a logistically and economically challenging task, and hydrogeologists are usually left with a sparse set of measurements from which to infer groundwater salinity over large spatial extents. Airborne electromagnetic (AEM) surveying is a geophysical technique for estimating the bulk electrical conductivity of the near-surface. Where AEM bulk conductivity is well correlated with groundwater salinity in aquifers, AEM is a useful tool for modelling salinity in the data sparse areas between boreholes. We present a probabilistic method for modelling groundwater salinity and a case study from the Keep River Plains in the Northern Territory. Co-located probabilistic AEM inversions and EC measurements on pore fluids at coincident locations were fused to calculate an empirical joint probability density function. This function allowed us to estimate salinity away from the bores by sampling the ensemble of AEM conductivities. Unlike deterministic methods that provide a single estimate of salinity, our method generates an ensemble of estimates, which can be used to quantify predictive uncertainty. The results provided by our method can feed into decision making while accounting for uncertainty, allowing responsible management of land and water resources., Open-Access Online Publication: March 03, 2023

This paper first examines the experimental results from a 16-h plasma-assisted gasification trial for conversion of refuse derived fuel (RDF) into syngas suitable for biofuel production in a pilot plant. In particular, the work focuses on the effect on the concurrent ash vitrification and tar reforming processes on the general composition of a syngas stream produced in a fluidized bed gasifier. The effect of plasma on tar reforming is showed by continuous monitoring of gas composition before and after the plasma converter, with reduction efficiencies typically exceeding 99%v/v for most hydrocarbons, SO2, NH3, NOx, and organic sulfur. The test also investigates on the effect of plasma intensity on different contaminants reforming and syngas conditioning when varying the input power value at cracking-relevant temperatures. A simplified catalytic test is undertaken under continuous flow of cleaned syngas generated by the pilot plant to identify the short-term effects of waste-derived contaminants on catalyst...

In the literature on innovation and organizational learning, there is a wide consensus about the relevance of learning activities. Specifically, they occur both individually (as producers will increase their knowledge simply “by doing”) and collectively (as producers and other stakeholders involved will learn “by interacting”). Therefore, in these studies, the focus on informal learning has become increasingly evident with recognition that informal learning predominates in smaller and locally-operating firms, and large corporations alike. The aim of the study is twofold; firstly to understand the link between formal networks and informal learning and secondly to investigate if the information exchanged in the network between firms and institutions is altered by content. Through a case study in Foggia, southern Italy, we have investigated how knowledge flows among small organic food firms and related supporting institutions. The core finding of the study was that the existence of networks is necessary to promote informal knowledge flows, yet not sufficient by itself. In conclusion, several obstacles had to be removed before producers gained from the positive effects of geographical clustering and proximity.

SUMMARYMulti-agency public protection arrangements (MAPPA) have been in operation for around 18 years in England and Wales. The primary purpose is for the sharing of information between agencies regarding the risk management of offenders returning to the community from custodial and hospital settings. The legal framework regarding information by psychiatrists is not dealt with in one single policy or guidance document. Psychiatrists must use their clinical and professional judgement when engaging with the MAPPA process, mindful of guidance available from professional bodies such as the Royal College of Psychiatrists, General Medical Council and British Medical Association.LEARNING OBJECTIVESAfter reading this article you will be able to: •Learn the legal and political background that led to the formation of MAPPA•Understand the structure and function of MAPPA•Understand the role of psychiatrists in the MAPPA processDECLARATION OF INTERESTR.T. is a member of the London Strategic Management Board for MAPPA.

The purpose of this study was to identify an effective lipid oxidation initiator which could predict, within one month, the long-term oxidative stability of a prototype skincare formulation. The main purpose is to find a potential initiator not to assess oxidation stability of the formulations. FOUR INITIATORS (BELOW) WERE EXAMINED IN THREE STEPS: 1. Reaction kinetics using a Clark electrode (Oxygraph); 2. Effect of adding an initiator on the product's physical and oxidative stability in prototype skincare formulations by visual observation, peroxide value and headspace GC-MS determination of volatile oxidation products; and 3. Ability to differentiate unstable vs. stable prototype creams by initiator addition. The four initiators explored were: FeCl2/H2O2 , FeCl3 /ascorbic acid, 2,2'-Azobis(2,4-dimethylvaleronitrile) (AMVN) and 2,2'-Azobis(2-methylpropionamidine) dihydrochloride (AAPH). In Oxygraph, the initiator systems FeCl2/H2O2 and FeCl3/ascorbic acid were good accelerators of oxygen consumption. The addition of FeCl2/H2O2 to prototype formulations did not affect the physical stability. However, the addition of FeCl3/ascorbic acid to prototype formulations resulted in phase separation and FeCl3/ascorbic acid was therefore deemed unusable. Moreover, the addition of AAPH or AMVN resulted in an increased and decreased viscosity, respectively. In the oxidation stability study, peroxide value increased significantly when AMVN was added. However, the peroxide value remained low for the other initiators and the control (no initiator). The secondary volatile oxidation product, butanal, increased most with the FeCl2/H2O2 addition. Three out of the four initiators did not have the ability to rank the stable and unstable formulations in accordance with the result obtained for volatile oxidation products after 42 days of storage at 20°C of formulations without initiator. Only, FeCl2/H2O2 was able to rank the formulations in accordance with the oxidative stability observed for volatile oxidation products after 42 days of storage. FeCl2/H2O2 showed potential as an initiator to predict the oxidative stability of skincare formulations, but more studies are needed to confirm the result in a broader range of products over a longer time. This article is protected by copyright. All rights reserved.

The European Union (EU) is increasingly connected to the rest of the world via flows of people, capital, goods and resources, exposing it to the potential impacts of climate change occurring outside its borders, in addition to impacts occurring on and between EU countries themselves. However, there is currently no peer-reviewed literature that describes the way in which cross-border impacts might affect the EU as a whole, or what the pattern of exposure to cross-border impacts might look like from a European perspective. This paper describes the pathways via which the EU may be impacted and analyses indicator data to identify some of the potential key issues for EU adaptation. We find that many EU countries are more exposed than the global average to climate-related risks in the context of transboundary water dependency, trade openness, openness to asylum and globalisation. We introduce a typology of cross-border climate change impacts to guide future assessments and adaptation planning in the European Union: EU internal aspects resulting from climate risks shared between neighbouring member states and within the single market; EU external aspects resulting from climate impacts beyond the EU’s borders; and EU impacts on the rest of the world, recognising that the EU and its member states will themselves transmit impacts to others depending on the success of their own adaptation efforts. Cross-border climate impacts raise a number of challenges for EU adaptation—such as applying existing cohesion and external action mechanisms to build resilience to cross-border climate change impacts, or monitoring member states to track changes in exposure to “internal” cross-border climate risks; and to research—such as making better use of economic, trade and other supply chain modelling and data analysis to assess climate-related risks, as well as other methods and approaches that have not been applied widely in adaptation studies to date. Overcoming these challenges will help to advance society’s understanding of and preparedness for cross-border climate change impacts.

Compared to the synthesis of polyurethane polymers, construction of well-defined polyurethane dendrimers is challenging due to the high reactivity of externally added or in-situ formed isocyanates leading to the formation of side products. For this reason, the synthesis of dendritic polyurethanes is limited to very few reports. With primary focus of dendrimer research on the interaction of the periphery and the core, we report the synthesis of a common polyurethane dendron, which allows for late-stage variation of both the periphery and the core. The periphery can be varied simply by installing a clickable unit in the dendron and then attaching to the core and vice-versa. Thus, a common dendron allows for varying periphery and core in just two steps. To accomplish this, protecting group free one-pot multicomponent Curtius reaction was utilized to afford a robust and versatile AB2 type polyurethane dendron employing commercially available simple molecules 5-hydroxyisophthalic acid, 11-bromoundecanol, and 4- penten-1-ol. Subsequent late-stage modification of either dendrons or dendrimers via thiol-ene click reaction gave surface?functionalized alternating aromatic-aliphatic polyurethane homodendrimers to generation-three (G3). The dendrons and the dendrimers were characterized by NMR, mass spectrometry, and FT-IR analysis. A bifunctional AB2 type dendritic monomer demonstrated this approach's versatility that can either undergo a thiol-one click or attachment to the core. This approach enables the incorporation of functionalities at the periphery and the core that may not withstand the dendrimer growth for the synthesis of polyurethane dendrimers and other dendritic macromolecules

Without assuming prior legal knowledge, books in the Directions series introduce and guide readers through key points of law and legal debate. Questions, diagrams and exercises help readers to engage fully with each subject and check their understanding as they progress. A contract requires that the parties reach an agreement which normally consists of a matching offer and acceptance. This chapter discusses the following: the objective test of agreement; identifying an offer and acceptance; rejection, counter-offers and inquiries; communication of acceptance including the postal rule and the contrasting rule for revocation; mode of acceptance; the death of an offer; and unilateral contracts.

Without assuming prior legal knowledge, books in the Directions series introduce and guide readers through key points of law and legal debate. Questions, diagrams and exercises help readers to engage fully with each subject and check their understanding as they progress. This chapter discusses the various ways of classifying mistakes including communication mistakes, mistakes of fact, common mistake and unilateral mistake. It then looks at the case law on mistaken identity and the distinctions between face-to-face and correspondence contracts. Finally, it looks at the restrictive rules on common mistake, including the difference between fundamental mistake and mistake as to quality, and their relationship with the doctrine of frustration and the demise of the category of equitable mistake.

Without assuming prior legal knowledge, books in the Directions series introduce and guide readers through key points of law and legal debate. Questions, diagrams and exercises help readers to engage fully with each subject and check their understanding as they progress. This chapter examines the principles by which contractual damages are assessed. The discussions cover the aim of contractual damages, the difference between damages in contract and in tort; the relationship between the expectation interest and the reliance interest; cost of cure and difference in value; remoteness of damage; foreseeability and assumption of risk; non-pecuniary losses; mitigation; contributory negligence; and penalties, liquidated damages and forfeiture.

Without assuming prior legal knowledge, books in the Directions series introduce and guide readers through key points of law and legal debate. Questions, diagrams and exercises help readers to engage fully with each subject and check their understanding as they progress. This chapter examines the frustration of a contract. Fundamental changes in the facts assumed by the parties, ‘frustrating events’ such as natural disasters and less catastrophic events may fundamentally change the parties’ obligations and frustrate the contract. Frustration of a contract brings the parties’ obligations to an end; a less substantial, non-frustrating event will have no effect and the parties must continue to perform their obligations even if they have become more onerous. The discussions cover the allocation of risk, examples of frustration, limits on frustration, effects of frustration and the Law Reform (Frustrated Contracts) Act 1943.

Without assuming prior legal knowledge, books in the Directions series introduce and guide readers through key points of law and legal debate. Questions, diagrams and exercises help readers to engage fully with each subject and check their understanding as they progress. This chapter is concerned with the territory just beyond the borders of the contract, where we find the representations which are not part of the contract but which influenced its creation and which, if false, are remedied by the law on misrepresentation. The discussions cover the key elements of the definition of misrepresentation; the differences between fraudulent, negligent and innocent misrepresentations; and the remedies of rescission and the various rights to damages. This also includes the bars on the right to rescind, the principles of assessment of damages and the controls on excluding liability for misrepresentation.

Without assuming prior legal knowledge, books in the Directions series introduce and guide readers through key points of law and legal debate. Questions, diagrams and exercises help readers to engage fully with each subject and check their understanding as they progress. This introductory chapter explains how contract law is structured and how it fits into the overall scheme of the law of obligations and into English law more generally. It explains the boundaries between contract law, torts and unjust enrichment and restitution. It also explains the wider range of situations covered by the law of contract, and puts the law of contract into its social and economic context.

Concerning approaches and communications to the Royal Family and other British public figures are relatively numerous. This paper examines over 2000 such cases logged over a three-year period in the United Kingdom. Using police and health data, the paper conducts a series of bivariate and multivariate analyses to demonstrate the predictors of what types of risk are posed by an individual case (e.g., communicate only, approach, security breach). The results showed that (a) the rates of serious mental disorders are higher among this sample than the general population base rate, (b) approachers were significantly more likely than communicators to suffer from serious mental disorders, (c) approachers were significantly more likely than communicators to have a history of substance use and abuse problems, (d) approachers were significantly more likely than communicators to have a history of violent behavior against property and persons, and (e) the motivations of approachers and communicators significantly differ. The paper concludes with a consideration of the implications for threat assessment and management.

Given a set of candidate projects, selecting and scheduling an optimal subset of the projects is a complex problem faced by many organizations. This problem is referred to as the Project Portfolio Selection and Scheduling Problem (PPSSP) and is known to be NP-hard. In the defence sector, the PPSSP arises as a sub-process of Future Force Design (FFD), which is a strategic planning task that assists in the decision making process for future defence force capability programming. The PPSSP faced in the defence context has its own set of challenges above and beyond those typical of the problem. As such, this study investigates a formulation of the PPSSP inspired by the FFD process in the context of the Australian Department of Defence (DoD). Given the NP-hard nature of the problem, four metaheuristics are examined on large-scale synthetic data sets. Three different solution representations are examined and results are compared against solutions provided by a commercial exact solver. Results indicate that there is no observed significant difference in total portfolio value attained by the proposed meta-heuristic approaches and the commercial solver, thereby justifying their usage in this domain.