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Prioritising PPCR Investments in Mozambique: The Politics of ‘Country Ownership’ and ‘Stakeholder Participation’

Mozambique is both one of the poorest countries and one with the highest level of vulnerability to multiple potential consequences of climate change, including drought, flood, sea level rise and increased frequency and severity of tropical cyclones – making it a natural candidate for inclusion in the Pilot Program for Climate Resilience (PPCR), which aims to help poorer countries to integrate climate change response into their national development processes. This article examines the process of prioritising investments under the PPCR in Mozambique, and asks to what extent this process has demonstrated the ‘country ownership’ and ‘broad participation’ which the PPCR claims to promote. It particularly focuses on the coastal cities component of the programme, and the question of whether the opposition?controlled port city of Beira should receive priority in PPCR investments

The Political Dimension of Vulnerability: Implications for the Green Climate Fund

As the availability of adaptation finance for developing countries increases, so does the need for a transparent way of prioritising countries for the allocation of money. It is intuitive that some countries are more vulnerable to climate change than others, and that countries that are particularly vulnerable should be given priority for adaptation finance. However, research has shown that science cannot be relied upon for a single objective ranking of vulnerability. This article analyses how the Global Climate Change Alliance (GCCA), the Pilot Program for Climate Resilience (PPCR) and the Adaptation Fund currently make decisions on adaptation finance allocations. It finds that each of the funds uses vulnerability to prioritise among countries, but the criteria applied vary and other criteria also play a role. Thus, vulnerability is politically, as well as scientifically, ambiguous. The Cancun Agreements have not resolved this, leaving a challenge for the Green Climate Fund

Combined Therapy of Orthopedic Surgery after Deep Brain Stimulation in Cerebral Palsy Mixed Type - A Case Report -

Dystonia is a symptom defined by involuntary and irregular contractions of the muscles, which cause movement disorders and postural problems. Deep brain stimulation (DBS) in globus pallidus interna (GPi) is a good option for controlling dystonia. DBS has already been shown to have significant effects on primary dystonia as well as Parkinson's disease. Dystonia is very difficult to manage, as seen in cerebral palsy (CP) mixed with spasticity. As CP patients grow, their musculoskeletal problems may require orthopedic surgery. However, the outcome of orthopedic surgery is not usually suitable due to dystonia. Therefore, we attempted to control dystonia through DBS initially and perform orthopedic surgery to correct musculoskeletal deformities after treatment of dystonia. Herein, we report a case that showed remarkable improvement in terms of the dystonia rating scale and gait pattern after combined therapy of DBS and orthopedic surgery

Photoproduction and electroproduction of charm at high energies

We estimate the differential and total cross sections for both the photoproduction of vector D*-meson and its yield in deep inelastic scattering at the HERA collider in the framework of model motivated by perturbative calculations in QCD. The offered model allows us to take into account higher twists over the transverse momentum of meson at p_T ~ m_c and to correctly approach the dominance of $c$-quark fragmentation at p_T >> m_c. We consider a possibility for the hadronization of color-octet c q-bar state into the meson. The combined contribution by the singlet and octet-color terms results in a good agreement with the experimental data for both the photoproduction and the production in deep inelastic scattering.Comment: 27 pages, ReVTeX, 8 eps-figures, explanations added, results unchange

Fosmetpantotenate Randomized Controlled Trial in Pantothenate Kinase–Associated Neurodegeneration

Fosmetpantotenate; Randomized controlled trialFosmetpantotenato; Ensayo controlado aleatorizadoFosmetpantotenat; Assaig controlat aleatoritzatBackground Pantothenate kinase–associated neurodegeneration (PKAN) currently has no approved treatments. Objectives The Fosmetpantotenate Replacement Therapy pivotal trial examined whether treatment with fosmetpantotenate improves PKAN symptoms and stabilizes disease progression. Methods This randomized, double-blind, placebo-controlled, multicenter study evaluated fosmetpantotenate, 300 mg oral dose three times daily, versus placebo over a 24-week double-blind period. Patients with pathogenic variants of PANK2, aged 6 to 65 years, with a score ≥6 on the PKAN-Activities of Daily Living (PKAN-ADL) scale were enrolled. Patients were randomized to active (fosmetpantotenate) or placebo treatment, stratified by weight and age. The primary efficacy endpoint was change from baseline at week 24 in PKAN-ADL. Results Between July 23, 2017, and December 18, 2018, 84 patients were randomized (fosmetpantotenate: n = 41; placebo: n = 43); all 84 patients were included in the analyses. Six patients in the placebo group discontinued treatment; two had worsening dystonia, two had poor compliance, and two died of PKAN-related complications (aspiration during feeding and disease progression with respiratory failure, respectively). Fosmetpantotenate and placebo group PKAN-ADL mean (standard deviation) scores were 28.2 (11.4) and 27.4 (11.5) at baseline, respectively, and were 26.9 (12.5) and 24.5 (11.8) at week 24, respectively. The difference in least square mean (95% confidence interval) at week 24 between fosmetpantotenate and placebo was −0.09 (−1.69 to 1.51; P = 0.9115). The overall incidence of treatment-emergent serious adverse events was similar in the fosmetpantotenate (8/41; 19.5%) and placebo (6/43; 14.0%) groups. Conclusions Treatment with fosmetpantotenate was safe but did not improve function assessed by the PKAN-ADL in patients with PKAN.The FORT trial was supported by Retrophin, Inc

Towards an understanding of the political economy of the PPCR

While an analysis of the Pilot Program for Climate Resilience (PPCR) is inseparable from wider discussion on adaptation finance, this article primarily focuses on the drivers and ideologies that shaped the PPCR governance and delivery structures. The core narrative of mainstreaming adaptation into development through a process of government-centred policy reform challenges many principles of the UNFCCC process. Utilising the structures of international financing institutions as implementing agencies, heightens this tension. The central idea of mainstreaming adaptation through climate-proofing existing development initiatives utilises the standard economic growth narrative. This climate ‘add-on’ approach to development allows the World Bank Group and other multilateral development banks (MDBs) to claim a space in managing future climate finance flows. This drive by the Bank plays out in the exclusivity of the design process for the PPCR and through the implementation modalities, which severely curtail opportunities for multi-stakeholder dialogue and thus the potential for development of broad country ownership of programmes

Negotiating Climate Resilience in Nepal

One of the key drivers of the global political economy of climate change is the evolving financial architecture; yet there is little research into how this plays out at the national level. How will the new ideas and ideologies be received and interpreted in national policymaking arenas? What does this mean for how power, processes and resources are negotiated and institutionalised? This article addresses these questions through a case study analysis of the Pilot Program for Climate Resilience (PPCR) in Nepal. We examine how the global objectives of the PPCR are being interpreted and re?conceptualised by different actors; and how this conceptualisation is influenced by, and reinforces or challenges, existing political ideologies and interests. We suggest that attention to these dynamics could help resolve some emerging tensions as the PPCR moves forwards towards implementation