Перспективы финансирования проектов инфраструктуры: инвестиции, взаимодействие и доверие в межкультурном контексте

Project fnance of infrastructure (e.g. exploitation and transportation of natural resources, high speed railways, internet) forms a basis for the peaceful development and the prosperity of nations as well as the transnational community. What is needed are dependable networks in a world in transition, where digitalisation and new powers demand joint action. Particularly in the Eurasian region, from Lisbon to Vladivostok, felds with future prospects are opening up for Russia, Germany and the European union. We can develop them through investment and cooperation, by building up trust through common rules and sustainable substance. Here, a concept for this is presented for “Intercultural Project Finance”: An order of law and business (order of assets; German: Vermoegensordnung), in which state and private actors build up the necessary trust and are able to co-operate and proft transnationally for the good of the common prosperity of all peoples. A key element of a suitable system for the investment of capital (transnational investor protection law) is a sustainable valuation law; this has to be developed and etablished by legal comparison. In the following, relevant aspects for theory and practice which are basic for the actors of infrastructure project fnance will be shown, as well as the new initiative of the European union regarding “Connectivity”.Финансирование проектов инфраструктуры (например, эксплуатация и транспортировка природных ресурсов, высокоскоростные железные дороги, Интернет) формирует основу для мирного развития и процветания народов разных стран, а также транснационального сообщества. В условиях меняющегося мира, где цифровизация и новые власти требуют совместных действий, необходимы надежные межкультурные связи. В частности, в Евразийском регионе, от Лиссабона до Владивостока, открываются перспективы для России, Германии и Европейского союза. Эти связи можно развивать через инвестиции и сотрудничество, укрепляя доверие с помощью общих правил и стабильного состояния. В статье представлена концепция «Межкультурного финансирования проектов»: регламент бизнеса и права (порядок активов; нем.: Vermoegensordnung), в котором государственные и частные субъекты формируют необходимое доверие и способны сотрудничать и получать прибыль на транснациональном уровне на благо общего процветания всех народов. Ключевым элементом системы, подходящей для инвестирования капитала (закон о защите транснациональных инвесторов), является закон об устойчивой оценке; он должен быть разработан и установлен путем правового сравнения. Показаны соответствующие аспекты теории и практики, которые являются основными для участников финансирования проектов инфраструктуры, а также новая инициатива Европейского союза в отношении межкультурного взаимодействия

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

A ring trial to harmonize Toxoplasma gondii microsatellite typing: comparative analysis of results and recommendations for optimization

International audienceAbstract A ring trial among five European laboratories was organized to reach consistency in microsatellite (MS) typing of the zoonotic parasite Toxoplasma gondii . Three sample sets were circulated and analyzed by each laboratory following a previously published method that is based on fragment length polymorphism of 15 MS markers. The first sample set compared typing results in general and focused on effects of DNA concentration; the second sample set focused on the polymorphic fingerprinting markers that can differentiate T. gondii strains within the same archetypal lineage; and the third set focused on non-archetypal genotypes. Methodological variations between laboratories, including the software programs used to determine MS fragment length, were collated using a questionnaire. Overall, lineage-level typing results reached a high level of agreement, especially in samples with the highest DNA concentrations. However, laboratory-specific differences were observed for particular markers. Major median differences in fragment length, of up to 6 base pairs, were related to the fluorophore used to label fragment-specific primers. In addition, primer pairs with identical sequences obtained from different suppliers resulted in fragments of differing length. Furthermore, differences in the way the sequencing profiles were assessed and interpreted may have led to deviating results in fragment length determination. Harmonization of MS typing, for example, by using the same fluorophores or by numerical adjustments applied to the fragment-lengths determined, could improve the uniformity of the results across laboratories. This is the first interlaboratory comparison, providing guidelines (added as a supplement) for the optimization of this technique