Norms from the periphery: tracing the rise of the common but differentiated principle in international environmental politics

Over the last three decades, constructivist scholars of international relations have created a rich body of literature on the influence of global norms. Until recently, the vast majority of that work focused on norms originating in the developed world and neglected the ideational impact of developing countries. This article confronts this oversight in the literature by tracing the rise of the “common but differentiated responsibility” (CBDR) norm in international environmental politics. The CBDR principle traces its origins to the developing world and today it is part of the framework principles of international environmental agreements. Thus, it represents a global norm promoted by, rather than diffused to, the developing world. In the process of tracing this norm’s rise, this article generates a set of hypotheses about the conditions under which developing countries create global norms

Corticosteroid use endpoints in neuro-oncology: Response Assessment in Neuro-Oncology Working Group

Background:Corticosteroids are the mainstay of treatment for peritumor edema but are often associated with significant side effects. Therapies that can reduce corticosteroid use would potentially be of significant benefit to patients. However, currently there are no standardized endpoints evaluating corticosteroid use in neuro-oncology clinical trials. Methods:The Response Assessment in Neuro-Oncology (RANO) Working Group has developed consensus recommendations for endpoints evaluating corticosteroid use in clinical trials in both adults and children with brain tumors. Results:Responders are defined as patients with a 50% reduction in total daily corticosteroid dose compared with baseline or reduction of the total daily dose to ≤2 mg of dexamethasone (or equivalent dose of other corticosteroid); baseline dose must be at least 4 mg of dexamethasone daily (or equivalent dose of other corticosteroids) for at least one week. Patients must have stable or improved Neurologic Assessment in Neuro-Oncology (NANO) score or Karnofsky performance status score or Eastern Cooperative Oncology Group (ECOG) (Lansky score for children age <16 y), and an improved score on a relevant clinical outcome assessment tool. These criteria must be sustained for at least 4 weeks after baseline assessment to be considered a response, and are confirmed 4 weeks after that (ie, 8 wk after baseline assessment) to be considered a sustained response. Conclusions:This RANO proposal for corticosteroid use endpoints in neuro-oncology clinical trials may need to be refined and will require prospective validation in clinical studies