Review of solar PV policies, interventions and diffusion in East Africa

Previous research on the diffusion of solar PV in Africa has mainly focused on solar home systems (SHS) in individual countries and thus overlooked developments in other PV market segments that have recently emerged. In contrast this paper adopts a regional perspective by reviewing developments in supportive policies, donor programs and diffusion status in all PV market segments in Kenya, Tanzania and Uganda, as well as identifying the key factors put forward in the literature to explain differences in the diffusion of SHS in these three countries. The paper finds two emerging trends: (i) a movement from donor and government-based support to market-driven diffusion of solar PV; and (ii) a transition from small-scale, off-grid systems towards mini-grids and large-scale, grid-connected solar power plants. The paper points out three generic factors that have contributed to encouraging SHS diffusion in all three countries: (i) the decline in world market prices for PV modules; (ii) the prolonged support from international donors; and (iii) conducive framework conditions provided by national governments. The paper also identifies five key factors that have been elaborated in the literature to explain the higher level of SHS diffusion in Kenya compared to Tanzania and Uganda: (i) a growing middle-class; (ii) geographical conditions; (iii) local sub-component suppliers; (iv) local champions; and (v) business culture. Finally, the paper discusses the lack of attention in the literature given to analysing the amount, nature and timing of donor and government support across countries, processes of learning and upgrading in local PV industries and the interaction between the different explanatory factors

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Designing Affordable Housing out of Shipping Containers for Chicago (Semester Unknown) IPRO 339: DesigningAffordableHousingOutOfShippingContainersForChicagoIPRO339FinalReportSu09

The City of Chicago has been nominated as the U.S. Bid City for 2016 Olympic Games and currently remains a strong contender for this title. If Chicago is selected as the Host City it will face the enormous task of providing temporary housing for all Olympiad participants including athletes, coaches, organizers, and media reporters. Continuing in the vein of last semester’s IPRO, our IPRO is proposing an economical and environmentally friendly solution to this challenge. We propose to utilize thousands of old shipping containers that are cluttering up shipping yards in the Chicago area and to convert them into low-cost housing units. With proper foresight, this challenge can become an opportunity for the I P R O 3 3 9 City to demonstrate an attitude of sustainability that can serve as a model for other cities around the world to follow suit. The intense media attention directed towards the Olympic Games could be channeled to showcase our commitment to environmentally and socially responsible actions.Deliverable

Designing Affordable Housing out of Shipping Containers for Chicago (Semester Unknown) IPRO 339: DesigningAffordableHousingOutOfShippingContainersForChicagoIPRO339BrochureSu09

The City of Chicago has been nominated as the U.S. Bid City for 2016 Olympic Games and currently remains a strong contender for this title. If Chicago is selected as the Host City it will face the enormous task of providing temporary housing for all Olympiad participants including athletes, coaches, organizers, and media reporters. Continuing in the vein of last semester’s IPRO, our IPRO is proposing an economical and environmentally friendly solution to this challenge. We propose to utilize thousands of old shipping containers that are cluttering up shipping yards in the Chicago area and to convert them into low-cost housing units. With proper foresight, this challenge can become an opportunity for the I P R O 3 3 9 City to demonstrate an attitude of sustainability that can serve as a model for other cities around the world to follow suit. The intense media attention directed towards the Olympic Games could be channeled to showcase our commitment to environmentally and socially responsible actions.Deliverable