Structured Funds: A balancing act between financial sustainability and development impact

It is estimated that up to 4.5 trillion US dollars in global investment are needed every year to achieve the Sustainable Development Goals (SDGs). Innovative financing approaches that aim to increase the involvement of private actors in development finance are therefore increasing in importance. One of these approaches is structured funds. They include different risk categories, in order to meet the needs of different investors. Official donors assume the highest risk category, thus reducing the risk for private investors. So far, only little is known about the development impact of this financing approach, which needs to balance its objectives of financial sustainability and development impact. Against this backdrop, this evaluation examines the alignment of this financing approach with the objectives of German development cooperation, its potential for mobilising private capital, its financial sustainability, and its effects on financial intermediaries (FIs) and the extent to which sub-borrowers are reached. For this purpose a theory-based approach was selected that integrates qualitative and quantitative methods of analysis. Based on its findings, the evaluation makes recommendations concerning financial sustainability, political management, donor coordination, mobilising private capital and managing development impact

Strukturierte Fonds: Ein Finanzierungsansatz im Spannungsfeld zwischen finanzieller Nachhaltigkeit und entwicklungspolitischer Wirkung

Um die Ziele für nachhaltige Entwicklung zu erreichen, werden jährlich globale Investitionen von bis zu 4,5 Billionen US-Dollar benötigt. Innovative Finanzierungsansätze zur Einbindung privater Akteure in die Entwicklungsfinanzierung gewinnen somit zunehmend an Bedeutung. Zu diesen Ansätzen zählen Strukturierte Fonds. Sie beinhalten verschiedene Risikoklassen, um unterschiedlichen Investoren gerecht zu werden. Öffentliche Geber übernehmen die höchste Risikoklasse und verringern so das Investitionsrisiko für private Investoren. Bisher ist wenig über die Wirksamkeit des Finanzierungsansatzes bekannt, der sich im Spannungsfeld zwischen seinem Anspruch an finanzielle Nachhaltigkeit und seinen entwicklungspolitischen Zielen bewegt. Vor diesem Hintergrund untersucht die Evaluierung die Einbettung des Finanzierungsansatzes in die Ziele deutscher Entwicklungszusammenarbeit, sein Potenzial zur Mobilisierung privater Mittel, seine finanzielle Nachhaltigkeit sowie seine Wirkung auf Finanzintermediäre und die Erreichung von Endkreditnehmenden. Dafür wurde ein theoriebasierter Ansatz gewählt, der qualitative und quantitative Analysemethoden integriert. Basierend auf den Ergebnissen spricht die Evaluierung Empfehlungen in Bezug auf finanzielle Nachhaltigkeit, entwicklungspolitische Steuerung, Geberkoordinierung, Mobilisierung privater Mittel und Nachhaltung der entwicklungspolitischen Wirkung aus

Microsatellite instability is highly prevalent in older patients with colorectal cancer

BackgroundClinical guidelines suggest screening of colorectal cancer (CRC) for microsatellite instability (MSI). However, microsatellite instability—high (MSI-H) CRC is not rare in older patients. This study aimed to investigate the prevalence of MSI-H CRC in an unselected population in an age-based manner.Material and methodsA retrospective analysis of data from patients undergoing radical surgery for CRC was performed. Only cases with results from MSI testing using immunochemistry (IHC) were analyzed. Age-based analyses were performed using two cut-off ages: 50 years. as stated in Amsterdam II guidelines, and 60 years. as outlined in the revised Bethesda criteria.ResultsThe study population included 343 (146 female and 197 male) patients with a median age of 70 years (range 21–90 years). The prevalence of MSI-H tumors in the entire cohort was 18.7%. The prevalence of MSI-H CRC was 22.5% in the group ≤50 years vs. 18.2% in the group >50 years using the age limit in the Amsterdam II guidelines. MSI-H CRC was present in 12.6% of the group aged ≤60 years compared to 20.6% in the control group >60 years.ConclusionMSI screening of CRC based on age alone is associated with negative selection of a relevant number of cases. MSI-H CRC is also common in elderly patients, who may be negatively selected secondary to an age-based screening algorithm. Following the results of this study, screening based on clinical criteria should be omitted in favor of systematic screening as is already internationally practiced

The State of the Evidence on Blended Finance for Sustainable Development: An Evidence Gap Map

Blended finance, which aims to mobilise private capital towards sustainable development in developing countries (OECD, 2018), is becoming increasingly important for bridging the investment gap for the Sustainable Development Goals (SDGs). However, little is known about its development impact. This report presents the findings of a systematic search on blended finance studies and evaluations, which are visualised as an evidence gap map (EGM). The EGM presents the resultson a matrix of eight blended finance instruments and 14 sub-effects, which were grouped into four categories of effects: financial additionality, development additionality, market development and sector effects. The search identified 33 publications that met the inclusion criteria, containing 87 individual pieces of evidence. Almost half of the blended finance instruments focused on results-based incentives, with grants and guarantees being the next most numerous. Most of the evidence was found in programme evaluation reports (67%), while (quasi-)experimental evidence was scarce (12%). The comparison with a blended finance database (Convergence, 2020) showed that the increase in the size of the blended finance market from USD 16 billion in 2007 to USD 136 billion in 2018 did not trigger a similar increase in research. A particularly strong mismatch between frequency of use and lack of research was found for insurance, hedging and junior/subordinated capital, and for sector effects in energy and financial services.Blended Finance zielt darauf ab, privates Kapital für die Finanzierung nachhaltiger Entwicklung zu mobilisieren (OECD, 2018) und wird immer wichtiger, um die Investitionslücke für die Erreichung der Nachhaltigkeitsziele (Sustainable Development Goals, SDGs) zu schließen. Bisher ist jedoch wenig über die entwicklungspolitische Wirkung von Blended Finance bekannt. Dieser Bericht stellt die Ergebnisse einer systematischen Suche nach Blended Finance Studien und Evaluierungen vor, die als Evidenzkarte (Evidence Gap Map, EGM) visualisiert sind. Die EGM bildet die Evidenz auf einer Matrix von acht Blended-Finance-Instrumenten und 14 Subeffekten ab, die unter vier Kategorien fallen: finanzielle Additionalität, entwicklungspolitische Additionalität, Marktentwicklung und Sektoreffekte. Die Suche ergab 33 Publikationen, die die Kriterien erfüllten. Diese enthielten 87 Einzelergebnisse (pieces of evidence), von denen sich fast die Hälfte auf das Blended-Finance-Instrument der ergebnisorientierten Anreize bezog, gefolgt von Garantien und Zuschüssen. Die meiste Evidenz stammt aus Programmevaluierungsberichten (67%), während (quasi-)experimentelle Evidenz nur selten vorhanden ist (12%). Der Vergleich mit einer Blended-Finance-Datenbank (Convergence, 2020) zeigte, dass der Anstieg der Größe des Blended Finance Markts seit 2007 nicht mit einem ähnlichen Anstieg an Publikationen einherging. Eine besonders starke Diskrepanz zwischen tatsächlicher Nutzung und mangelnder Evidenz wurde bei Versicherungen, Hedging und nachrangigem/nachrangigem Kapital sowie bei Sektoreffekten in den Bereichen Energie und Finanzdienstleistungen festgestellt

Inhibition of HSP90 as a Strategy to Radiosensitize Glioblastoma: Targeting the DNA Damage Response and Beyond

Radiotherapy is an essential component of multi-modality treatment of glioblastoma (GBM). However, treatment failure and recurrence are frequent and give rise to the dismal prognosis of this aggressive type of primary brain tumor. A high level of inherent treatment resistance is considered to be the major underlying reason, stemming from constantly activated DNA damage response (DDR) mechanisms as a consequence of oncogene overexpression, persistent replicative stress, and other so far unknown reasons. The molecular chaperone heat shock protein 90 (HSP90) plays an important role in the establishment and maintenance of treatment resistance, since it crucially assists the folding and stabilization of various DDR regulators. Accordingly, inhibition of HSP90 represents a multi-target strategy to interfere with DDR function and to sensitize cancer cells to radiotherapy. Using NW457, a pochoxime-based HSP90 inhibitor with favorable brain pharmacokinetic profile, we show here that HSP90 inhibition at low concentrations with per se limited cytotoxicity leads to downregulation of various DNA damage response factors on the protein level, distinct transcriptomic alterations, impaired DNA damage repair, and reduced clonogenic survival in response to ionizing irradiation in glioblastoma cells in vitro. In vivo, HSP90 inhibition by NW457 improved the therapeutic outcome of fractionated CBCT-based irradiation in an orthotopic, syngeneic GBM mouse model, both in terms of tumor progression and survival. Nevertheless, in view of the promising in vitro results the in vivo efficacy was not as strong as expected, although apart from the radiosensitizing effects HSP90 inhibition also reduced irradiation-induced GBM cell migration and tumor invasiveness. Hence, our findings identify the combination of HSP90 inhibition and radiotherapy in principle as a promising strategy for GBM treatment whose performance needs to be further optimized by improved inhibitor substances, better formulations and/or administration routes, and fine-tuned treatment sequences

Alternative Presents for Dynamic Fabric

In this paper we investigate how a combination of "speculative" design methods can be used to generate theoretical understandings for dynamic, colour-changing fabrics for garments. Specifically, we combine a first-person, autobiographical, research through design (RtD) approach that draws strategies from speculative design. We call this approach alternative presents, inspired by the work of James Auger, and explore it as a way to generate theoretical propositions for dynamic fabric that emphasize the lived experience over technological innovation. The contributions of this framing are twofold. Firstly, we offer a theoretical contribution to the literature on dynamic fabric. Secondly, we make a methodological contribution for how autobiographical design and RtD can be oriented speculatively to generate intermediate knowledge, with particular emphasis on social-technical aspects

Susceptibility and Antibody Response of the Laboratory Model Zebra Finch (Taeniopygia guttata) to West Nile Virus

Since the introduction of West Nile virus (WNV) into North America in 1999 a number of passerine bird species have been found to play a role in the amplification of the virus. Arbovirus surveillance, observational studies and experimental studies have implicated passerine birds (songbirds, e.g., crows, American robins, house sparrows, and house finches) as significant reservoirs of WNV in North America, yet we lack a tractable passerine animal model for controlled studies of the virus. The zebra finch (Taeniopygia guttata) serves as a model system across a diversity of fields, and here we develop the zebra finch a songbird model for WNV. Like many natural hosts of WNV, we found that zebra finches developed sufficient viremia to serve as a competent host, yet in general resisted mortality from infection. In the Australian zebra finch (AZF) T. g. castanotis, we detected WNV in the majority of sampled tissues by 4 days post injection (dpi). However, WNV was not detected in tissues of sacrificed birds at 14 dpi, shortly after the development of detectable anti-WNV antibodies in the majority of birds indicating successful viral clearance. We compared susceptibility between the two zebra finch subspecies AZF and Timor zebra finch (TZF) T. g. guttata. Compared to AZF, WNV RNA was detected in a larger proportion of challenged TZF and molecular detection of virus in the serum of TZF was significantly higher than in AZF. Given the observed moderate host competence and disease susceptibility, we suggest that zebra finches are appropriate as models for the study of WNV and although underutilized in this respect, may be ideal models for the study of the many diseases carried and transmitted by songbirds

Evaluierungssynthese Zusammenarbeit mit der Privatwirtschaft

Die Zusammenarbeit zwischen entwicklungspolitischen Akteuren und der Privatwirtschaft gewinnt immer mehr an Bedeutung, da sich die entwicklungspolitische Gemeinschaft davon unter anderem die Mobilisierung zusätzlicher Ressourcen zur Erreichung der Nachhaltigkeitsziele (Sustainable Development Goals, SDGs) verspricht. Ob die Ziele der Zusammenarbeit erreicht werden, wurde bisher jedoch nur in Evaluierungen und Studien zu einzelnen Vorhaben und Instrumenten erforscht. Die Evaluierungssynthese versucht diese Lücke zu schließen, indem sie bestehende Evidenz aus der nationalen und der internationalen Entwicklungskooperation zur Zusammenarbeit mit der Privatwirtschaft systematisch analysier

Evaluation Synthesis - Private Sector Engagement

Cooperation between development policy actors and the private sector is becoming increasingly important, among other reasons because the development community anticipates that it will mobilise additional resources for achieving the Sustainable Development Goals (SDGs). Until now, however, the only research on whether the goals of such cooperation have been achieved has taken the form of evaluations and academic studies on individual projects and instruments. This evaluation synthesis attempts to fill this gap by systematically analysing the available evidence on private sector engagement within German and international development cooperation. Overall, the evaluations and studies included in the analysis report mainly positive effects on investors and donors, intermediaries, partner countries and target groups. However, various analyses, including an assessment of the quality of the evaluations, suggest that a positive-results bias is present. The evaluation synthesis puts forward recommendations on defining indicators, on measuring and assessing impacts and additionality, on knowledge management, and on considering the transaction costs involved in cooperating with private sector actors

Improving the Preoperative Diagnostic Accuracy of Acute Appendicitis. Can Fecal Calprotectin Be Helpful?

Is the patient really suffering from acute appendicitis? Right lower quadrant pain is the most common sign of acute appendicitis. However, many other bowels pathologies might mimic acute appendicitis. Due to fear of the consequences of delayed or missed diagnosis, the indication for emergency appendectomy is liberally made. This has been shown to be associated with high rates of negative appendectomy with risk of potentially serious or lethal complications. Thus there is need for a better preoperative screening of patients with suspected appendicitis.This prospective single center single-blinded pilot study was conducted in the Department of surgery at the HELIOS Universitätsklinikum Wuppertal, Germany. Calprotectin was measured in pre-therapeutic stool samples of patients presenting in the emergency department with pain to the right lower quadrant. Fecal calprotectin (FC) values were analyzed using commercially available ELISA kits. Cut-off values for FC were studied using the receiver-operator characteristic (ROC) curve. The Area under the curve (AUC) was reported for each ROC curve.The mean FC value was 51.4 ± 118.8 μg/g in patients with AA, 320.9 ± 416.6 μg/g in patients with infectious enteritis and 24.8 ± 27.4 μg/g in the control group. ROC curve showed a close to 80% specificity and sensitivity of FC for AA at a cut-off value of 51 μg/g, AUC = 0.7. The sensitivity of FC at this cut-off value is zero for enteritis with a specificity of 35%.Fecal calprotectin could be helpful in screening patients with pain to the right lower quadrant for the presence of acute appendicitis or infectious enteritis with the aim of facilitating clinical decision-making and reducing the rate of negative appendectomy