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This paper draws on a multimethod ethnographic study, conducted between 2016 and 2017 in Shirebrook, Derbyshire, England—a small and relatively isolated deindustrialising colliery town—examining how residents negotiate living in stigmatised territory. In doing so, microspatial strategies of distancing, avoidance, and deflection are illustrated, revealing how residents reassign and deepen stigma in particular locations within a stigmatised territory. This highlights the relationship between social and physical space, and while spatial strategies of negotiation do not mitigate stigma, they do (re)produce internal social hierarchies within a place that is homogenised from the outside through disparaging narratives. A key contribution reveals the significance of the racialised production of space in shaping how territorial stigma is negotiated within this distinct socio-spatial location. Residents use strategies to redirect the stigma toward those seen as out of place and draw attention away from sticky sites of racialised urban stigma towards symbols of unspoilt rural Englishness.

The conflict in Ukraine indicates some of the features of a potential post-liberal order and raises several potential ethical issues that may arise for international interventions as the world changes. What types of interventions, if any, are justifiable in response to situations such as the one in Ukraine? Can interventions be permissible given the potential undermining of universalist claims that are often used to support them? How should states prioritize between situations if there is an even greater number of global challenges in a post-liberal order? Three new books—Solferino 21 by Hugo Slim, Decolonizing Human Rights by Abdullahi Ahmed An-Naim, and Promoting Justice across Borders by Lucia Rafanelli—can help to navigate these questions. Drawing on their insights, this essay argues that reform interventions can be justified to defend the liberal international order, that intervention can be defended from a relativist basis, and that socioeconomic rights should be given greater priority.

This paper draws on data collected from a multimethod ethnographic study to contribute to debates on the production of territorial stigmatisation through the analysis of Shirebrook, UK: a small post-industrial mining town in Derbyshire, which now houses the distribution centre and warehouse of Sports Direct, recently the subject of high-profile scrutiny in the UK over working conditions. Combining semi-structured interviews, participant observation and the analysis of documentary sources, I argue that the territorial stigmatisation of Shirebrook does not emanate from a single source. Rather, multiple institutions and agents converge in the co-production of stigma. The analysis draws attention to local antagonisms and hierarchies in the production of stigma, demonstrating how relatively powerful actors ‘below’ do not simply resist or deflect stigma onto less powerful others, but influence the way that territorial stigma operates, problematising Wacquant's top-down conceptualisation.

This article considers the implications of a post-liberal order for the international responsibility to protect. It focuses on two questions. First, what challenges will the international responsibility to protect face in a post-liberal order? Second, in light of these challenges, how would the requirements of the international responsibility to protect differ in the post-liberal order? In response to the first question, the article argues that in a post-liberal order the international responsibility to protect is likely to be subject to the “Influence Challenge,” whereby its ability to constrain and influence states decreases. In response to the second question, it argues that the requirements of the international responsibility to protect would be affected in several ways, including necessitating greater consideration of questions of prioritization and requiring a re-evaluation, and potential abandonment, of the currently predominant approach to the responsibility to protect.

Given the multiple threats of atrocities in the world at any given time, where should states direct their attention and resources? Despite the rich and extensive literature that has emerged on the responsibility to protect (RtoP), little thought has been given to the question of how states and other international actors should prioritize when faced with multiple situations of ongoing and potential atrocities. As part of the roundtable “The Responsibility to Protect in a Changing World Order: Twenty Years since Its Inception,” in this essay we first demonstrate the importance of questions of prioritization for RtoP. We then delineate some of the issues involved in assessing the issue of prioritization, beginning with what we call the “basic maximization model,” and introducing additional atrocity-specific and response-specific issues that also need to be considered. We also emphasize the importance of considering how the need to address mass atrocities should be weighed against other global responsibilities, such as those concerning global poverty, global health, and climate change. We thereby set an agenda for future discussions.

This article presents findings collected in 2016-2017 from a multi-method ethnographic study of Shirebrook, Derbyshire in the English East Midlands, examining the narratives used by the local authority (LA) and local residents that construct immigration as a social problem. In doing so, it contributes to the literature on race and migration by extending analysis beyond metropolitan localities with long histories of multi-ethnic settlement, to consider a relatively small, peripheral former colliery town. The paper demonstrates how migration is framed as a social problem by central government funding streams with consequences for localities, and the influence this has on local narratives of social change. The construction of immigration as a social problem is rooted in the constraints of austerity and longer-term processes of deindustrialization and economic restructuring, with representations and understandings of place being constitutive of anti-immigrant sentiment. This article deepens our understanding of responses to immigration in the UK, and has broader implications for understanding the relationship between place, state polices and local narratives.

The cyber realm is increasingly vital to national security, but much of cybersecurity is provided privately. Private firms provide a range of roles, from purely defensive operations to more controversial ones, such as active-cyber defense (ACD) and ‘hacking back’. As with the outsourcing of traditional military and security services to private military and security companies (PMSCs), the reliance on private firms raises the ethical question of to what extent the private sector should be involved in providing security services. In this article, I consider this question. I argue that a moderately restrictive approach should be adopted, which holds that private firms can justifiably launch some cybersecurity services – defensive measures – but are not permitted to perform others – offensive measures.

Background/Aims IgG4 related disease (IgG4-RD) is a rare immune-mediated condition, increasingly being recognised as a multi-organ disorder. It is a relatively new entity and the precise prevalence is not known. It is a chronic fibro-inflammatory condition with raised circulating levels of immunoglobulin G4 and accumulation of plasma cells and fibrosis in the affected tissue. We report a retrospective observational study of patients with IgG4 related disease (IgG4-RD). Methods We conducted a retrospective observational study of patients seen at Guy’s and St Thomas’ NHS Foundation Trust Hospitals, London, UK. The data collected was analysed for clinical presentation, laboratory markers of inflammation, immunoglobulin subsets, autoantibody profiles, imaging and histopathology and compared to the 2019 ACR/EULAR criteria to determine a confirmed diagnosis of IgG4-RD. Data was also collected post standard-of-care treatment, including patient clinical outcomes and possible improvement. Results The study included a multi-ethnic cohort of 83 patients with multi-organ involvement. Fifty-nine of the eighty-three patients were classified as confirmed IgG4-RD (71%). Seventy one patients had biopsies of which 49 of the 59 (91%) confirmed IgG4-RD patients had biopsies consistent with IgG4-RD. Fifty patients underwent PET-CT scanning of which uptake was seen in 76% of those with confirmed IgG4-RD (26/34). Immunoglobulin IgG subclass analysis showed significantly higher IgG4 levels in the confirmed IgG4-RD group as compared to possible IgG4. Treatments were with corticosteroids and immunosuppressants such as azathioprine, methotrexate, mycophenolate, cyclophosphamide and rituximab. P167 Table 1:IgG4 levels and inflammatory markers for pre and post treatment groupsPre-RxPost-Rxp-valueCRPmean29 mg/l9 mg/l0.0298*Range0-300 mg/l1-70 mg/lESRmean35 mm/hr17 mm/hr0.0002*Range2-131 mm/hr1-74 mm/hrSerum IgG4mean4.9 g/L2.83 g/L0.0001*Range0.1-24.2 g/L0.02-13.3 g/L Conclusion IgG4-RD is a fibro-inflammatory disorder involving multiple organs. If not treated adequately may develop severe organ damage. It often responds to corticosteroids but may require other immunosuppressive therapy. Treatment with biologics such as B cell depletion therapy results are encouraging. Disclosure S. Sangle: None. N.T. Morton: None. A. Casian: None. L. Nel: None. J. Hanna: None. A. Fernando: None. R. Bell: None. P. Taylor: None. J. Pattison: None. T. O'Brien: None. D. D'Cruz: None.

If the resources used to wage wars could be spent elsewhere and save more lives, does this mean that wars are unjustified? This article considers this question, which has been largely overlooked by Just War Theorists and pacifists. It focuses on whether the opportunity costs of war lead to a form of pacifism, which it calls ‘Opportunity Costs Pacifism’. The article argues that Opportunity Costs Pacifism is, at the more ideal level, compelling. It suggests that the only plausible response to Opportunity Costs Pacifism applies in highly nonideal circumstances. This has major implications for Just War Theory and pacifism since it is only at the highly nonideal level that war can be justified.

Background and objectives Minimal change disease is an important cause of nephrotic syndrome in adults. Corticosteroids are first-line therapy for minimal change disease, but a prolonged course of treatment is often required and relapse rates are high. Patients with minimal change disease are therefore often exposed to high cumulative corticosteroid doses and are at risk of associated adverse effects. This study investigated whether tacrolimus monotherapy without corticosteroids would be effective for the treatment of de novo minimal change disease. Design, setting, participants, & measurements This was a multicenter, prospective, open-label, randomized, controlled trial involving six nephrology units across the United Kingdom. Adult patients with first presentation of minimal change disease and nephrotic syndrome were randomized to treatment with either oral tacrolimus at 0.05 mg/kg twice daily, or prednisolone at 1 mg/kg daily up to 60 mg daily. The primary outcome was complete remission of nephrotic syndrome after 8 weeks of therapy. Secondary outcomes included remission of nephrotic syndrome at 16 and 26 weeks, rates of relapse of nephrotic syndrome, and changes from baseline kidney function. Results There were no significant differences between the tacrolimus and prednisolone treatment cohorts in the proportion of patients in complete remission at 8 weeks (21 out of 25 [84%] for prednisolone and 17 out of 25 [68%] for tacrolimus cohorts; P=0.32; difference in remission rates was 16%; 95% confidence interval [95% CI], −11% to 40%), 16 weeks (23 out of 25 [92%] for prednisolone and 19 out of 25 [76%] for tacrolimus cohorts; P=0.25; difference in remission rates was 16%; 95% CI, −8% to 38%), or 26 weeks (23 out of 25 [92%] for prednisolone and 22 out of 25 [88%] for tacrolimus cohorts; P=0.99; difference in remission rates was 4%; 95% CI, −17% to 25%). There was no significant difference in relapse rates (17 out of 23 [74%] for prednisolone and 16 out of 22 [73%] for tacrolimus cohorts) for patients in each group who achieved complete remission (P=0.99), or in the time from complete remission to relapse. Conclusions Tacrolimus monotherapy can be effective alternative treatment for patients wishing to avoid steroid therapy for minimal change disease. Podcast This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2020_01_16_CJN06180519.mp3

Although often overlooked, positive incentives can play a key role in tackling aggression, human rights abuses, and the spread of weapons of mass destruction. In this essay, I focus on one form of positive incentives: covert incentives. First, I argue that covert incentives are preferable to overt incentives since they enable policymakers to eschew the shackles of public opinion and avoid worries of moral hazard and the corruption of international society. Second, I argue that covert incentives are often more justifiable than covert force since they do not involve problematic methods and do not make it easier to undertake military action. Accordingly, I conclude that there is a prima facie duty to employ covert positive incentives as opposed to overt incentives and covert force.

Despite the numerous frameworks for assessing ethical issues within foreign policy, more general accounts on the ethics of foreign policy that unite these various areas have not yet emerged. This article therefore aims to sketch a general framework for the ethics of foreign policy, which I call the “Pragmatic Approach”. In doing so, it considers why Just War Theory is not suitable as the basis for a framework for the ethics of foreign policy. It also shows how the Pragmatic Approach can be used to make judgements on three different foreign policy issues: the ethics of signing a new trade deal, the ethics of negotiating with unfriendly states, and the ethics of launching drone strikes.

Class is back – class inequalities now feature centrally in multiple media, are core to campaigns and protest movements, and are a part of everyday conversation. Mitigating the adverse effects of class again plays a key role in policy formation and formal politics. James Pattison and Tracey Warren consider how far the UK’s approach meets or falls below the types and levels of action that any liberal democracy requires.

The UK’s Changing Democracy presents a uniquely democratic perspective on all aspects of UK politics, at the centre in Westminster and Whitehall, and in all the devolved nations. The 2016 referendum vote to leave the EU marked a turning point in the UK’s political system. In the previous two decades, the country had undergone a series of democratic reforms, during which it seemed to evolve into a more typical European liberal democracy. The establishment of a Supreme Court, adoption of the Human Rights Act, Scottish, Welsh and Northern Irish devolution, proportional electoral systems, executive mayors and the growth in multi-party competition all marked profound changes to the British political tradition. Brexit may now bring some of these developments to a juddering halt. The UK’s previous ‘exceptionalism’ from European patterns looks certain to continue indefinitely. ‘Taking back control’ of regulations, trade, immigration and much more is the biggest change in UK governance for half a century. It has already produced enduring crises for the party system, Parliament and the core executive, with uniquely contested governance over critical issues, and a rapidly changing political landscape. Other recent trends are no less fast-moving, such as the revival of two-party dominance in England, the re-creation of some mass membership parties and the disruptive challenges of social media...

After 9/11, the American intelligence community (IC) grew from few to uncountable, and the money allocated to the community could only be guessed at, given the secret and other funds that accompanied allocated funds for expanding intelligence capability. Out of this spiraling confusion, the Department of Homeland Security (DHS) was born to coordinate the disparate efforts of known and lesser-known intelligence organizations. However, the DHS could not handle the tremendous IC activity by himself, and by 2010, the Office of the Director of National Intelligence (ODNI), the Top Intelligence Officer in America was additionally established. Most of the work in bringing the IC together has been done by the DHS. It seems to have been successful in identifying the directions from which a threat may enter into the country. Where the effort is lacking is when terror comes from so-called “home-grown” or unaffiliated terrorists. For these, a neighborly approach is best, and can be accomplished with minimal investment. The DHS has implemented a reporting system, together with reporting training, which will allow local law enforcement personnel to participate in the national security effort by logging their observations and disseminating them throughout the DHS system. That system is designed not just to collect information, but to share it with participating agencies (including local law enforcement). Part of this initiative is the “See Something, Say Something” campaign that involves private citizens in the national security effort. Of all of the ODNI and DHS efforts, the private citizen observation campaign holds the most realistic promise and provides the best lesson for nations that would learn from the American terrorism response experience.

Mercury cadmium telluride (MCT) epilayers have been grown on CdTe/Si using molecular beam epitaxy and 8-μm-deep mesa structures formed using plasma etching. Following previous work done on etching mesas and subjecting material to thermal cycle annealing, we set out to determine the limits and underlying physics of dislocation reduction in mesa-etched and annealed MCT. This paper describes the dependence of dislocation reduction on anneal time, cycle annealing, temperature, and etch depth. We show dislocation density reduction below 3 × 105 cm−2 in 10-μm-wide, long-bar mesas along the \( [0\bar{1}1] \) orientation with only a 5-min anneal at 400°C.

This article presents the ethical case for diplomatic criticism as a response to mass atrocities and serious external aggression. It argues, in short, that states have a moral duty to criticise the offending parties. More specifically, it argues that diplomatic criticism is often a plausible and preferable alternative to other means of addressing serious external aggression and mass atrocities (such as war, economic sanctions and other diplomatic measures). It also argues that diplomatic criticism is often preferable to doing nothing, and that even if other means are undertaken, states should engage in diplomatic criticism as well. There are two subsidiary aims of the article. The first is to reject some of the worries surrounding international hypocrisy - I aim to show that even hypocritical diplomatic criticism may be obligatory. The second is to highlight the impact on Just War Theory of considering in more detail the ethical issues raised by the alternatives to war, such as diplomatic criticism, and, more specifically, to present a new account of the last resort principle, which I call 'Presumptive Last Resort'.

This chapter considers diplomatic measures, including diplomatic criticism (naming and shaming), dialogue and mediation, the cutting of diplomatic ties, and the denial of membership of an international body. The first part of the chapter focuses on diplomatic criticism, arguing that it can help to address the situation, contribute to morally valuable international norms, and even punish offenders. In doing so, it considers the objection that diplomatic criticism is too demanding and that states are not entitled to criticize others when they are being hypocritical. More broadly, the chapter establishes the moral importance of expressing condemnation and upholding morally valuable international norms. The chapter also generally defends the case for mediation, negotiation, and denial of membership, but rejects the utility of the cutting of diplomatic ties.

This chapter delineates the theoretical and practical implications of the preceding analysis. It first summarizes the case for each of the alternatives in turn, before considering the implications for war. In doing so, the chapter highlights the two central themes of the book: (1) there are several normative reasons in favour of the alternatives and (2) there are further objections to war. It argues that, although the preceding analysis appears to strengthen the case for pacifism (since there is more to the alternatives than it often seems), it also poses a challenge to it. The chapter then outlines the implications for the jus ad bellum principle of last resort. It defends an account of ‘Presumptive Last Resort’, which holds that war should be presumed to be the last feasible option. It also outlines five implications for the responsibility to protect doctrine.

This chapter considers arms embargoes. It first examines the idealized case for arms embargoes, which holds that they reduce the aggressors’ access to weapons and frustrate their goals, whilst distributing the costs fairly and avoiding doing harm. It then assesses the vehement, nonideal critique of arms embargoes in some of the academic literature. This highlights various problems such as that they are violated by sender states, that weapons are still obtained on the black market and through porous borders, and that they are used to avoid undertaking more effective action. The chapter challenges this nonideal critique and argues that the idealized account is in fact largely correct: arms embargoes do often work once we adopt the correct measure of effectiveness (what it calls ‘morally valuable effectiveness’). In doing so, this chapter provides a defence of the importance and meaning of effectiveness—the central factor on the Pragmatic Approach.

This chapter considers the case for military assistance to rebels and states. It first rejects three considerations that one might think provide sufficient reason to uphold an absolute prohibition on arming rebels. To that extent, it might (exceptionally) be permissible to arm rebels. The chapter argues, though, that arming rebels should generally be eschewed. This is because of the problems raised by the ‘Rebel-Risk Objection’, the ‘Escalation Objection’, and the ‘Diffusion Objection’. The chapter also argues that many of these objections apply to arming states. In doing so, it also largely repudiates the case for arming states against non-state actors engaged in aggression and mass atrocities.

This chapter considers the use of economic, political, and legal incentives. After presenting three notable reasons for using positive incentives—including the fact that they are not coercive—it considers several objections to their use. These include, centrally, the worry that they reward those who commit egregious wrongdoing and therefore are problematic in terms of desert. It also considers the potential moral hazard that such inducements will encourage others to commit wrongdoing and the potential for incentives to ‘crowd out’ intrinsic motivation and to undermine morally valuable international norms and laws. Although the chapter largely defends the case for positive incentives, it rejects the case for international amnesties and exile.

If states are not to go to war, what should they do instead? In The Alternatives to War: From Sanctions to Non-violence, James Pattison considers the case for the alternatives to military action to address mass atrocities and aggression. He covers the normative issues raised by measures ranging from comprehensive economic sanctions, diplomacy, and positive incentives, to criminal prosecutions, non-violent resistance, accepting refugees, and arming rebels. For instance, given the indiscriminateness of many sanctions regimes, are sanctions any better than war? Should states avoid ‘megaphone diplomacy’ and adopt more subtle measures? What, if anything, can non-violent methods such as civilian defence and civilian peacekeeping do in the face of a ruthless opponent? Is it a serious concern that positive incentives can appear to reward aggressors? Overall, Pattison provides a comprehensive account of the ethics of the alternatives to war. In doing so, he argues that the case for war is weaker and the case for many of the alternatives is stronger than commonly thought. The upshot is that, when reacting to mass atrocities and aggression, states are generally required to pursue the alternatives to war rather than military action. Pattison concludes that this has significant implications for pacifism, Just War Theory, and the responsibility to protect doctrine.

This chapter explicates the Pragmatic Approach, which is used to assess the ethics of the alternatives to war. This approach is pragmatic in that it is significantly instrumentalist and takes seriously the nonideal and contingent features of the contemporary international system. The chapter first outlines a series of tests any moral theory should meet, before going on to present the central features of the Pragmatic Approach. The chapter then defends this approach, showing how it meets the four tests outlined and is superior to alternative approaches. It also delineates the links to Just War Theory, and especially the jus ad bellum principles of necessity and proportionality. The end of the chapter considers how the values on the Pragmatic Approach should be weighed.

This chapter considers non-violent methods. The first part of the chapter largely defends the case for civilian peacekeeping and, in doing so, delineates how this measure can be effective despite being unarmed. The chapter also highlights the limitations of civilian peacekeeping, including its small scale. The second part of this chapter considers civilian defence against an external aggressor. Although the chapter argues that this may sometimes work, it also highlights one central limitation: it is unlikely to be effective against an aggressor that does not wish to occupy. Overall, the chapter argues that non-violence can play some role in tackling conflict, human rights abuses, and mass atrocities. Notwithstanding, the chapter also makes it clear that these non-violent options should not generally be undertaken at the expense of more coercive ones, such as traditional peacekeeping and military defence, but instead sometimes used in addition to these methods.

This chapter considers the case for economic sanctions, both targeted and comprehensive. It challenges the prevailing view on the morality of economic sanctions, which holds that sanctions (including to some degree targeted sanctions) are highly objectionable. To do so, it considers and replies to four central objections to economic sanctions. These are the ‘Indiscriminate Objection’, which asserts that sanctions are impermissible because of their apparent indiscriminateness, the ‘Intending-the-Harm Objection’, which holds that sanctions are highly problematic because they involve means that intend harms, the ‘Instrumentalization Objection’, which holds that sanctions wrongly use the suffering of innocents as a mere means, and the ‘Ineffectiveness Objection’, which holds that sanctions are ineffective. Having rejected the central arguments against sanctions, the chapter then argues that sanctions can be favourable in at least one respect: they can more fairly distribute the currently inevitable harms to innocents of tackling aggression and mass atrocities.

This chapter considers measures that often aim to tackle mass atrocities and external aggression as a secondary aim. It focuses on three measures: actions by the International Criminal Court (ICC), (2) accepting refugees, and (3) humanitarian assistance. The chapter examines the question of whether we should frame these measures as major policy options to tackle mass atrocities and serious external aggression. On the one hand, it argues that international criminal prosecutions by the ICC should be seen as a central part of the toolkit for responses to mass atrocities. This is despite worries about its politicization and linking it to R2P. On the other hand, it argues that we should not view accepting refugees and humanitarian aid as part of the R2P toolkit, in large part due to worries about buck-passing.

This chapter considers the Responsibility to Protect (R2P) in the context of broader debates in International Political Theory. First, it suggests that central to the appeal—and success—of R2P is that its central premises strike a plausible balance between statist and cosmopolitan concerns. Second, it argues, notwithstanding, that R2P still faces challenges from statism and cosmopolitanism, including the apparent statism of R2P’s pillar II and the worries amongst certain non-Western states that R2P still has an unduly strong liberal cosmopolitan bent. Third, it argues that much of the recent debate on R2P about the efficacy of the norm is somewhat unproductive because this depends on a tricky counterfactual judgement about the utility and feasibility of potential alternative norms. The chapter concludes by arguing that a far more pertinent (and neglected) issue is how much political will should be invested in R2P, relative to other, morally valuable agenda.

From January 2015 to December 2017, approximately 1.6 million migrants crossed the Mediterranean to reach Europe. The death toll was dramatic, with almost 15,000 drowning. In response to the void left by the ending of the Italian-led Mare Nostrum mission, several non-governmental organizations (NGOs) launched their own search and rescue (SAR) operations, rescuing over 110,000 migrants. In this article, we argue that states have the responsibility not only to coordinate, but also to directly provide adequate SAR operations in the Mediterranean, and that these responsibilities are presently being abdicated. Although much criticism of NGO maritime rescuing operations is misplaced, non-governmental SAR has notable limitations, and states are ultimately responsible for this shortfall.

Background The ability to distinguish malignant from benign retroperitoneal fibrosis (RPF) and to select patients who are likely to respond to steroid treatment using a noninvasive test would be a major step forward in the management of patients with RPF. Objective To prospectively evaluate the potential of [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) to improve clinical decision-making and management of RPF. Design, setting, and participants A total of 122 RPF patients were assessed and managed by a multidisciplinary RPF service between January 2012 and December 2015. Of these, 78 patients underwent 101 FDG-PET scans, as well as computed tomography and blood tests. Management was based on the findings from these investigations. Median follow-up was 16 mo. Results and limitations Of the 24 patients with negative [18F]-FDG-PET, none (0%) had malignancy on biopsy (negative predictive value 100%). [18F]-FDG-PET identified malignancy in 4/4 patients (100%) before biopsy. All four patients had highly avid PET (maximum standardised uptake value ≥4) with atypical avidity distribution. [18F]-FDG-PET revealed avidity in 19/38 patients (50%) with normal inflammatory markers and no avidity in 10/63 patients (16%) with raised marker levels. Patients with highly avid PET were significantly more likely to respond to steroids compared to those with low avidity (9/11 [82%] vs 3/24 [12%]; p < 0.01) or negative PET (9/11 [82%] vs 0/14 [0%]; p < 0.01). Limitations include the small number of patients and the predominance of tertiary referrals, which may represent patients with particularly problematic RPF. Conclusions This study has established a promising role for [18F]-FDG-PET in optimising and individualising the treatment of RPF. Patient summary This study shows that [18F]-fluorodeoxyglucose positron emission tomography scans could reduce the need for biopsy in patients with retroperitoneal fibrosis (RPF). This technique can distinguish cancer from noncancerous RPF, and may be better than blood tests in assessing and monitoring RPF. It also appears to predict a patient's response to steroids, which should allow more individualised treatment.

This article argues that Hardeep Singh Puri’s Perilous Interventions fails to fully grasp the risk of perilous nonintervention. It makes two central points. First, the fallacious critique of intervention reflects a worryingly narrow understanding of the r2p, particularly its third pillar, which overlooks the contributions that the r2p can make more generally. Second, Puri’s account highlights a clear lack of responsible leadership on behalf of India, in particular in relation to its failure to support fully the ‘Responsibly while Protecting’ proposal and lack of critique of the foreign policy of Russia.

Policies developed at national levels can be unresponsive to local needs. Often they do not provide the rural poor with access to the assets and services they need to allow them to innovate and adapt to the ways that increased climate variability and change exacerbate challenges to basic securities – food, water, energy, and well-being. In development deficit circumstances, common pool resources are important for climate adaptation purposes. In order for climate adaptation actions to deliver resilience, local perspectives and knowledge need to be recognised and given due priority in formal planning systems. Basing formal adaptive development planning on local strategies can support and strengthen measures that people have been tested and know to work. Local climate adaptation through collective action can address current increases in climate variability, future incremental changes, and the need to transform existing systems to deal with qualitative shifts in climate. These types of adaptation can work in ...

This article considers the issue of who should rebuild after war. Many leading advocates of the relevance ofjus post bellumfor Just War Theory adhere to the ‘Belligerents Rebuild Thesis’, which holds that those who have been involved with the fighting – such as the victor, just belligerent, unjust aggressor or humanitarian intervener – should be tasked with the responsibility to rebuild. By contrast, this article argues that there is a collective, international duty to rebuild that should be assigned primarily according to the agent's ability to rebuild – and not necessarily to the belligerents. The article also claims that, in contrast to the prevailing view, considerations ofjus post bellumdo not play any moral role in the justifiability of a war. Accordingly, defending the Belligerents Rebuild Thesis by invoking the alleged moral relevance ofjus post bellumfor Just War Theory is mistaken.

There has been widespread and vociferous condemnation of Somali piracy and several states have used force against the pirates. This reflects the prevailing view of pirates as belligerents and aggressors who act wrongly. In this article, I challenge this view by defending the conditional moral permissibility of piracy. More specifically, I first argue that piracy can be morally permissible when certain conditions are met. These are what I call the principles of ‘justa piratica’, that is, the principles of just piracy. Second, I claim that these conditions are likely to apply to some Somali pirates. Third, as a corollary, I argue that the case of piracy shows that one of the shibboleths of Just War Theory – that a war cannot be just on both sides – is mistaken.

This article considers the duty to undertake humanitarian intervention. It first examines the arguments for the duty to intervene and questions the possibility of supererogatory humanitarian intervention. It then considers the leading objections to this duty which, it is argued, are largely unpersuasive. In the final section, the article considers the duty to intervene in the context of the responsibility to protect doctrine, which provides the framework within which debates about humanitarian intervention now in large part occur.

Background The association between clinical events and everolimus exposure in patients receiving reduced-exposure calcineurin inhibitor therapy is poorly explored. Methods In a pre-planned, descriptive analysis of data from a randomized controlled trial, events were correlated with everolimus trough concentrations in 556 newly transplanted kidney transplant patients receiving everolimus with reduced-exposure cyclosporine (CsA) and steroids. Influence of everolimus exposure on clinical events was stratified according to predefined time-normalized concentrations. Results The incidence of treated biopsy-proven acute rejection and graft loss at month 12 was highest in patients with everolimus

Terrorism is a malignant threat to healthy thriving societies that oppose the ideologies that drive the terrorists. Answers to the problem and threat of terrorism are three-fold: deterrence, resistance, and response. Resilience to terrorism-induced trauma holds the key to defeating the effects of terrorism as well as deterring future acts. Deterrence founded upon healthy target society response to it is the best way to understand and approach terrorism and to educate supporters of terrorism that terror is a failed method. Organized terrorists fall into 3 categories: supporters, ideologue practitioners, criminals. Dissuading the supporters is the key to deterring organized terrorism. Supporters lose interest in terrorism when the effectiveness of the approach becomes too costly or is ineffectual. Societies that are resilient are the strongest lesson to educate rational calculating supporters: terrorism fails to bring desired change in resilient societies. The challenge for societies is to strengthen individuals and institutions that make society resilient.