Smart Havens Africa: Business Development Report

Based on market research and customer interviews, this report contains recommendations for SHA to alter its business model to improve customer experience and to create a marketing plan that effectively targets potential SHA customers that meet SHA’s social and financial needs

Smart Havens Africa: Preliminary Impact Report

This examines how SHA has impacted the lives of its current customers and establishes a system that will help SHA to continue tracking and analyzing its impact for years to come

Was the Little Ice Age more or less El Niño-like than the Medieval Climate Anomaly? Evidence from hydrological and temperature proxy data

This is the final version of the article. Available from European Geosciences Union via the DOI in this record.The El Niño–Southern Oscillation (ENSO) is the most important source of global climate variability on interannual timescales and has substantial environmental and socio-economic consequences. However, it is unclear how it interacts with large-scale climate states over longer (decadal to centennial) timescales. The instrumental ENSO record is too short for analysing long-term trends and variability and climate models are unable to accurately simulate past ENSO states. Proxy data are used to extend the record, but different proxy sources have produced dissimilar reconstructions of long-term ENSO-like climate change, with some evidence for a temperature–precipitation divergence in ENSO-like climate over the past millennium, in particular during the Medieval Climate Anomaly (MCA; AD  ∼  800–1300) and the Little Ice Age (LIA; AD  ∼  1400–1850). This throws into question the stability of the modern ENSO system and its links to the global climate, which has implications for future projections. Here we use a new statistical approach using weighting based on empirical orthogonal function (EOF) to create two new large-scale reconstructions of ENSO-like climate change derived independently from precipitation proxies and temperature proxies. The method is developed and validated using model-derived pseudo-proxy experiments that address the effects of proxy dating error, resolution, and noise to improve uncertainty estimations. We find no evidence that temperature and precipitation disagree over the ENSO-like state over the past millennium, but neither do they agree strongly. There is no statistically significant difference between the MCA and the LIA in either reconstruction. However, the temperature reconstruction suffers from a lack of high-quality proxy records located in ENSO-sensitive regions, which limits its ability to capture the large-scale ENSO signal. Further expansion of the palaeo-database and improvements to instrumental, satellite, and model representations of ENSO are needed to fully resolve the discrepancies found among proxy records and establish the long-term stability of this important mode of climatic variability.Many thanks to the Databases of the NOAA World Data Center for Paleoclimatology and Pangaea and all contributing authors for making available the proxy data used in this study. The GPCP and 20th Century Reanalysis V2 data were provided by the NOAA/ESRL/OAR-PSD, Boulder, Colorado, USA, from their website at http://www.esrl.noaa.gov/psd/. Support for the Twentieth Century Reanalysis Project dataset is provided by the US Department of Energy, Office of Science Innovative and Novel Computational Impact on Theory and Experiment (DOE INCITE) program, and the Office of Biological and Environmental Research (BER), and by the National Oceanic and Atmospheric Administration Climate Program Office. The GPCP combined precipitation data were developed and computed by the NASA/Goddard Space Flight Center’s Laboratory for Atmospheres as a contribution to the GEWEX Global Precipitation Climatology Project. We acknowledge the World Climate Research Programme’s Working Group on Coupled Modelling, which is responsible for CMIP, and we thank the climate modelling groups listed in Sect. B2 for producing and making available their model output. For CMIP the US Department of Energy’s Program for Climate Model Diagnosis and Intercomparison provides coordinating support and led development of software infrastructure in partnership with the Global Organization for Earth System Science Portals. L. Henke was supported by a University of Exeter Climate Change and Sustainable Futures studentship

The mechanisms of North Atlantic CO2 uptake in a large Earth System Model ensemble

The oceans currently take up around a quarter of the carbon dioxide (CO2) emitted by human activity. While stored in the ocean, this CO2 is not influencing Earth's radiation budget; the ocean CO2 sink therefore plays an important role in mitigating global warming. CO2 uptake by the oceans is heterogeneous, with the subpolar North Atlantic being the strongest CO2 sink region. Observations over the last 2 decades have indicated that CO2 uptake by the subpolar North Atlantic sink can vary rapidly. Given the importance of this sink and its apparent variability, it is critical that we understand the mechanisms behind its operation. Here we explore the combined natural and anthropogenic subpolar North Atlantic CO2 uptake across a large ensemble of Earth System Model simulations, and find that models show a peak in sink strength around the middle of the century after which CO2 uptake begins to decline. We identify different drivers of change on interannual and multidecadal timescales. Short-term variability appears to be driven by fluctuations in regional seawater temperature and alkalinity, whereas the longer-term evolution throughout the coming century is largely occurring through a counterintuitive response to rising atmospheric CO2 concentrations. At high atmospheric CO2 concentrations the contrasting Revelle factors between the low latitude water and the subpolar gyre, combined with the transport of surface waters from the low latitudes to the subpolar gyre, means that the subpolar CO2 uptake capacity is largely satisfied from its southern boundary rather than through air-sea CO2 flux. Our findings indicate that: (i) we can explain the mechanisms of subpolar North Atlantic CO2 uptake variability across a broad range of Earth System Models; (ii) a focus on understanding the mechanisms behind contemporary variability may not directly tell us about how the sink will change in the future; (iii) to identify long-term change in the North Atlantic CO2 sink we should focus observational resources on monitoring lower latitude as well as the subpolar seawater CO2; (iv) recent observations of a weakening subpolar North Atlantic CO2 sink may suggest that the sink strength has peaked and is in long-term decline.This work was supported by the EU FP7 Collaborative Project CarboOcean (Grant Agreement Number 264879), the Joint DECC/Defra Met Office Hadley Centre Climate Programme (GA01101), and the NERC directed research programme RAGNARoCC (NE/K002473/1)

A Microsoft-Excel-based tool for running and critically appraising network meta-analyses--an overview and application of NetMetaXL.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.BACKGROUND: The use of network meta-analysis has increased dramatically in recent years. WinBUGS, a freely available Bayesian software package, has been the most widely used software package to conduct network meta-analyses. However, the learning curve for WinBUGS can be daunting, especially for new users. Furthermore, critical appraisal of network meta-analyses conducted in WinBUGS can be challenging given its limited data manipulation capabilities and the fact that generation of graphical output from network meta-analyses often relies on different software packages than the analyses themselves. METHODS: We developed a freely available Microsoft-Excel-based tool called NetMetaXL, programmed in Visual Basic for Applications, which provides an interface for conducting a Bayesian network meta-analysis using WinBUGS from within Microsoft Excel. . This tool allows the user to easily prepare and enter data, set model assumptions, and run the network meta-analysis, with results being automatically displayed in an Excel spreadsheet. It also contains macros that use NetMetaXL's interface to generate evidence network diagrams, forest plots, league tables of pairwise comparisons, probability plots (rankograms), and inconsistency plots within Microsoft Excel. All figures generated are publication quality, thereby increasing the efficiency of knowledge transfer and manuscript preparation. RESULTS: We demonstrate the application of NetMetaXL using data from a network meta-analysis published previously which compares combined resynchronization and implantable defibrillator therapy in left ventricular dysfunction. We replicate results from the previous publication while demonstrating result summaries generated by the software. CONCLUSIONS: Use of the freely available NetMetaXL successfully demonstrated its ability to make running network meta-analyses more accessible to novice WinBUGS users by allowing analyses to be conducted entirely within Microsoft Excel. NetMetaXL also allows for more efficient and transparent critical appraisal of network meta-analyses, enhanced standardization of reporting, and integration with health economic evaluations which are frequently Excel-based.CC is a recipient of a Vanier Canada Graduate Scholarship from the Canadian Institutes of Health Research (funding reference number—CGV 121171) and is a trainee on the Canadian Institutes of Health Research Drug Safety and Effectiveness Network team grant (funding reference number—116573). BH is funded by a New Investigator award from the Canadian Institutes of Health Research and the Drug Safety and Effectiveness Network. This research was partly supported by funding from CADTH as part of a project to develop Excel-based tools to support the conduct of health technology assessments. This research was also supported by Cornerstone Research Group

Diffusion-Weighted Imaging Hyperintensities in Subtypes of Acute Intracerebral Hemorrhage: Meta-Analysis

BACKGROUND AND PURPOSE: Diffusion-weighted imaging (DWI) hyperintensities in intracerebral hemorrhage (ICH) are associated with increased risk of recurrent ICH, cognitive impairment, and death, but whether these lesions are specific to a subtype of ICH remains uncertain. We investigated the association between DWI lesions and ICH subtype and explored the risk factors for DWI lesions. METHODS: In a systematic review of ICH studies, we identified those reporting prevalence of DWI lesions. Two reviewers independently assessed study eligibility and risk of bias and collected data. We determined the pooled prevalence of DWI lesions within 90 days after ICH onset for cerebral amyloid angiopathy- and hypertensive angiopathy-related ICH using random-effects meta-analysis. We calculated odds ratios to compare prevalence of DWI lesions by ICH subtype and to assess risk factors for DWI lesions. RESULTS: Eleven studies (1910 patients) were included. The pooled prevalence of DWI lesions was 18.9% (95% CI, 11.1–26.7) in cerebral amyloid angiopathy- and 21.0% (95% CI, 15.3–26.6) in hypertensive angiopathy-related ICH. There was no difference in the prevalence of DWI lesions between cerebral amyloid angiopathy- (64/292 [21.9%]) and hypertensive angiopathy-related ICH (79/370 [21.4%]; odds ratio, 1.25; 95% CI, 0.73–2.15) in the 5 studies reporting data on both ICH pathogeneses. In all ICH, presence of DWI lesions was associated with neuroimaging features of microangiopathy (leukoaraiosis extension, previous ICH, and presence, and number of microbleeds) but not with vascular risk factors or the use of antithrombotic therapies. CONCLUSIONS: Prevalence of DWI lesions in acute ICH averages 20%, with no difference between cerebral amyloid angiopathy- and hypertensive angiopathy-related ICH. Detection of DWI lesions may add valuable information to assess the progression of the underlying microangiopathy

The functional and clinical outcomes of exercise training following a very low energy diet for severely obese women: Study protocol for a randomised controlled trial

BACKGROUND: Clinical practice guidelines globally recommend lifestyle modification including diet and exercise training as first-line treatment for obesity. The clinical benefits of exercise training in adults with obesity is well-documented; however, there is no strong evidence for the effectiveness of exercise training for weight loss in class II and class III obesity. The purpose of the randomised controlled trial described in this protocol article is to examine the effect of exercise training, in addition to a very low energy diet (VLED), in clinically severe obese women for changes in body composition, physical function, quality of life, and markers of cardiometabolic risk. METHODS/DESIGN: Sixty women, aged 18-50 years with a body mass index (BMI) greater than 34.9 kg.m(2) and at least one obesity-related co-morbidity, will be recruited for this 12-month study. Participants will be randomised to either exercise plus energy restriction (n = 30), or energy restriction alone (n = 30). All participants will follow an energy-restricted individualised diet incorporating a VLED component. The exercise intervention group will also receive exercise by supervised aerobic and resistance training and a home-based exercise programme totalling 300 minutes per week. Primary outcome measures include body composition and aerobic fitness. Secondary outcome measures include: physical function, cardiometabolic risk factors, quality of life, physical activity, and mental health. All outcome measures will be conducted at baseline, 3, 6 and 12 months. DISCUSSION: Previous research demonstrates various health benefits of including exercise training as part of a healthy lifestyle at all BMI ranges. Although clinical practice guidelines recommend exercise training as part of first-line treatment for overweight and obesity, there are few studies that demonstrate the effectiveness of exercise in class II and class III obesity. The study aims to determine whether the addition of exercise training to a VLED provides more favourable improvements in body composition, physical function, quality of life, and markers of cardiometabolic risk for women with clinically severe obesity, compared to VLED alone.<br /

One-pot synthesis and negative ion mass spectrometric investigation of a densely functionalized cinnoline, 3-amino-5,7,8-trichloro-6-hydroxycinnoline-4-carbonitrile

Known densely substituted 3-amino-5,7,8-trichloro-6-hydroxycinnoline-4-carbonitrile was synthesized using a new synthetic protocol involving chloranil and malonitrile via quinone methide formation. This one-pot synthesis occurs under base mediated conditions in a polar medium. The method involves condensation of excess malononitrile with chloranil in ethanol at reflux to 2-(2,4,5-trichloro-3-hydroxy-6-oxocyclohexa-2,4-dien-1-ylidene) malononitrile. This is an atom efficient, simple and effective procedure for the preparation of a highly substituted cinnoline that can serve as a relay to antimalarial prototypes