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National systems of innovation (NSIs) provide the context within which all processes of technology development, transfer and uptake occur - they refer to the network of actors (e.g. firms, universities, research institutes, government departments, NGOs) within which innovation occurs, and the strength and nature of the relationships between them. Nurturing NSIs in relation to climate technologies provides a powerful new focus for international policy with potential to underpin more sustained and widespread development and transfer of climate technologies. This working paper builds on an invited presentation by one of the authors at a workshop on NSIs convened by the Technology Executive Committee (TEC) of the United Nations Framework Convention on Climate Change (UNFCCC). It identifies policy recommendations for consideration of the TEC. The intention is both to inform possible recommendations by the TEC to the UNFCCC Conference of the Parties (COP) and to highlight potential areas for future work that the TEC could undertake on this issue.

National systems of innovation (NSIs) provide the context within which all processes of technology development, transfer and uptake occur - they refer to the network of actors (e.g. firms, universities, research institutes, government departments, NGOs) within which innovation occurs, and the strength and nature of the relationships between them. Nurturing NSIs in relation to climate technologies provides a powerful new focus for international policy with potential to underpin more sustained and widespread development and transfer of climate technologies. This working paper builds on an invited presentation by one of the authors at a workshop on NSIs convened by the Technology Executive Committee (TEC) of the United Nations Framework Convention on Climate Change (UNFCCC). It identifies policy recommendations for consideration of the TEC. The intention is both to inform possible recommendations by the TEC to the UNFCCC Conference of the Parties (COP) and to highlight potential areas for future work that the TEC could undertake on this issue.

This paper focuses on finance for Solar Home Systems (SHSs) in Kenya and asks to what extent emerging new finance approaches are likely to address the shortcomings of past approaches. Drawing on the STEPS Pathways Approach we adopt a framing that understands finance within a broader socio-technical context as a necessary but not sufficient component of achieving alternative pathways to sustainable energy access. The paper contributes in four ways. Firstly, it presents a comprehensive overview of past and new emerging approaches to financing SHSs in Kenya and their relative strengths and weaknesses. Secondly, it represents one of the first attempts in the literature to analyse the potential of new, real time monitoring technologies and pay as you go finance models to overcome the barriers faced by conventional consumer finance models for off-grid renewable energy technologies (RETs). Thirdly, by applying for the first time we are aware of a socio-technical approach, via the application of Strategic Niche Management (SNM) theory, to analyse the finance of RETs in developing countries, the analysis considers finance in the context of the social practices poor people seek to fulfil via access to the energy services that off-grid RETs provide, and the ways in which people previously paid for these services (e.g. via kerosene for lighting). This also situates the analysis within the understanding of SHSs as a niche that has to compete with the established regime of energy service provision and its attendant social and political institutional support. The paper therefore also contributes to the small but expanding body of literature that seeks to operationalise socio-technical transitions thinking and SNM within a developing country context.

This study, Updating the Case studies of the Political Economy of Science Granting Councils in sub-Saharan Africa, is a follow-up (Phase 2) to the case studies of the Political Economy of Science Granting Councils (SGCs) in sub-Saharan Africa research completed in 2017 (Phase 1, or baseline study). The study supports the Science Granting Councils Initiative (SGCI) in sub-Saharan Africa (SSA), funded by Canada's International Development Research Centre (IDRC), the UK Department for International Development (DFID) and South Africa's National Research Foundation (NRF). In the interest of generating evidence that can be deployed for economic and social development, the SGCI supports SGCs in 15 SSA countries. This research has been commissioned in response to an increasing recognition of the importance of improving understanding of the political economy (PE) of science and research in Africa and the roles that science, technology and innovation (STI)1play in the processes involved.The aims of the SGCI are to strengthen the capacity of SGCs to: manage research; design and monitor research programmes based on the use of robust STI indicators; support exchange of knowledge with the private sector; and establish partnerships among SGCs, and with other science system actors.

UK AID has recently invested in a new £39.8 million programme that aims to transform access to modern energy cooking services, or MECS, in Africa and Asia. In this working paper we demonstrate how reframing our understanding of how transformations happen in access to clean energy technologies, foregrounding the social and the political, together with more sophisticated, systemic understandings of how sustained technological change and innovation occurs, can increase the chances of transformative change that is environmentally sustainable and socially just. This moves beyond the largely unsuccessful track record of past interventions that tended to focus only on technology hardware and finance. The working paper analyses the case of Lighting Africa, which successfully transformed access to solar lighting in Kenya and, as far as we are aware, conceptualises and illustrates for the first time Lighting Africa's approach. This builds on past STEPS research that focusses on building sociotechnical innovation systems. The paper then compares the existing and planned activities of the MECS Programme in order to facilitate learning looking forward. This analysis is assisted by consideration of the important ways in which cooking as an energy service, and its related social practices, differs from lighting. It is also assisted by analysis of some critical social justice and political dimensions that were not explicitly addressed by Lighting Africa. As well as making substantive recommendations for the future operation of this £39.8 million programme of research and delivery, the working paper provides a useful illustration of how the STEPS Pathways Approach can contribute to applied analyses of policy and practice.

As SDG7-related interventions seek to transform access to clean energy, this paper presents an analysis of both a previous transformative intervention (Lighting Africa) and a theoretical approach to understanding how such transformations can be achieved in the Global South (socio-technical innovation system, STIS, building). The paper makes four contributions. First, it tests the extent to which the STIS-building concept is useful in understanding and conceptualising how Lighting Africa transformed the market for solar lanterns in Kenya from an estimated market size of 29,000 lamps in 2009 to one where 680,000 Lighting Africa certified lamps were sold in Kenya by the end of the Programme in 2013. Second, it presents the most in-depth analysis of Lighting Africa that we are aware of to date. Third, it presents a conceptual framework that illustrates the Lighting Africa approach, providing a framework for future policy interventions aiming to transform access to clean energy technologies in the Global South. Fourth, it reflects on weaknesses in the STIS approach. In particular, these include a need to better attend to: the gendered implications of interventions (and social justice more broadly); implications of different scales of technologies; value accumulation and the extent to which interventions benefit indigenous actors and local economies; and the political and economic implications of any intervention and its distribution of benefits.

The new European Union (EU) law governing the regulatory approval of medical devices that entered into force in May 2017 will now take effect from 26 May 2021. Here, we consider how it will change daily practice for cardiologists, cardiac surgeons, and healthcare professionals. Clinical evidence for any high-risk device must be reported by the manufacturer in a Summary of Safety and Clinical Performance (SSCP) that will be publicly available in the European Union Database on Medical Devices (Eudamed) maintained by the European Commission; this will facilitate evidence-based choices of which devices to recommend. Hospitals must record all device implantations, and each high-risk device will be trackable by Unique Device Identification (UDI). Important new roles are envisaged for clinicians, scientists, and engineers in EU Expert Panels-in particular to scrutinize clinical data submitted by manufacturers for certain high-risk devices and the evaluations of that data made by notified bodies. They will advise manufacturers on the design of their clinical studies and recommend to regulators when new technical specifications or guidance are needed. Physicians should support post-market surveillance by reporting adverse events and by contributing to comprehensive medical device registries. A second law on In Vitro Diagnostic Medical Devices will take effect from 2022. We encourage all healthcare professionals to contribute proactively to these new systems, in order to enhance the efficacy and safety of high-risk devices and to promote equitable access to effective innovations. The European Society of Cardiology will continue to advise EU regulators on appropriate clinical evaluation of high-risk devices.

The National Oceanographic Partnership Program (NOPP) consecutively sponsored the Ocean-Systems for Chemical, Optical, and Physical Experiments (O-SCOPE) and Multi-disciplinary Ocean Sensors for Environmental Analyses and Networks (MOSEAN) projects from 1998 through 2008. The O-SCOPE and MOSEAN projects focused on developing and testing new sensors and systems for autonomous, concurrent measurements of biological, chemical, optical, and physical variables from a diverse suite of stationary and mobile ocean platforms. Design considerations encompassed extended open-ocean and coastal deployments, instrument durability, biofouling mitigation, data accuracy and precision, near-real-time data telemetry, and economy—the latter being critical for widespread sensor and system utilization. The complementary O-SCOPE and MOSEAN projects increased ocean sensing and data telemetry capabilities for addressing many societally relevant problems such as global climate change, ocean carbon cycling and sequestration, acidification, eutrophication, anoxia, and ecosystem dynamics, including harmful algal blooms. NOPP support enabled O-SCOPE and MOSEAN to accelerate progress in achieving multiscale, multidisciplinary, sustained observations of the ocean environment. Importantly, both programs produced value-added scientific results, which demonstrated the utility of these new technologies. The NOPP framework fostered strong collaborations among academic, commercial, and government entities, and facilitated technology transfers to the general research community and to long-term observational and observatory programs.

The National Oceanographic Partnership Program (NOPP) consecutively sponsored the Ocean-Systems for Chemical, Optical, and Physical Experiments (O-SCOPE) and Multi-disciplinary Ocean Sensors for Environmental Analyses and Networks (MOSEAN) projects from 1998 through 2008. The O-SCOPE and MOSEAN projects focused on developing and testing new sensors and systems for autonomous, concurrent measurements of biological, chemical, optical, and physical variables from a diverse suite of stationary and mobile ocean platforms. Design considerations encompassed extended open-ocean and coastal deployments, instrument durability, biofouling mitigation, data accuracy and precision, near-real-time data telemetry, and economy—the latter being critical for widespread sensor and system utilization. The complementary O-SCOPE and MOSEAN projects increased ocean sensing and data telemetry capabilities for addressing many societally relevant problems such as global climate change, ocean carbon cycling and sequestration, acidification, eutrophication, anoxia, and ecosystem dynamics, including harmful algal blooms. NOPP support enabled O-SCOPE and MOSEAN to accelerate progress in achieving multiscale, multidisciplinary, sustained observations of the ocean environment. Importantly, both programs produced value-added scientific results, which demonstrated the utility of these new technologies. The NOPP framework fostered strong collaborations among academic, commercial, and government entities, and facilitated technology transfers to the general research community and to long-term observational and observatory programs.

The evaluation for European Union market approval of coronary stents falls under the Medical Device Directive that was adopted in 1993. Specific requirements for the assessment of coronary stents are laid out in supplementary advisory documents. In response to a call by the European Commission to make recommendations for a revision of the advisory document on the evaluation of coronary stents (Appendix 1 of MEDDEV 2.7.1), the European Society of Cardiology (ESC) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) established a Task Force to develop an expert advisory report. As basis for its report, the ESC-EAPCI Task Force reviewed existing processes, established a comprehensive list of all coronary drug-eluting stents that have received a CE mark to date, and undertook a systematic review of the literature of all published randomized clinical trials evaluating clinical and angiographic outcomes of coronary artery stents between 2002 and 2013. Based on these data, the TF provided recommendations to inform a new regulatory process for coronary stents. The main recommendations of the task force include implementation of a standardized non-clinical assessment of stents and a novel clinical evaluation pathway for market approval. The two-stage clinical evaluation plan includes recommendation for an initial pre-market trial with objective performance criteria (OPC) benchmarking using invasive imaging follow-up leading to conditional CE-mark approval and a subsequent mandatory, large-scale randomized trial with clinical endpoint evaluation leading to unconditional CE-mark. The data analysis from the systematic review of the Task Force may provide a basis for determination of OPC for use in future studies. This paper represents an executive summary of the Task Force's report.

Transformations to sustainability are increasingly the focus of research and policy discussions around the Sustainable Development Goals. However, the different roles played by transdisciplinary research in contributing to social transformations across diverse settings have been neglected in the literature. Transformative Pathways to Sustainability responds to this gap by presenting a set of coherent, theoretically informed and methodologically innovative experiments from around the world that offer important insights for this growing field. The book draws on content and cases from across the 'Pathways' Transformative Knowledge Network, an international group of six regional hubs working on sustainability challenges in their own local or national contexts. Each of these hubs reports on their experiences of 'transformation laboratory' processes in the following areas: sustainable agricultural and food systems for healthy livelihoods, with a focus on sustainable agri-food systems in the UK and open-source seeds in Argentina; low carbon energy and industrial transformations, focussing on mobile-enabled solar home systems in Kenya and social aspects of the green transformation in China; and water and waste for sustainable cities, looking at Xochimilco wetland in Mexico and Gurgaon in India. The book combines new empirical data from these processes with a novel analysis that represents both theoretical and methodological contributions. It is especially international in its scope, drawing inputs from North and South, mirroring the universality of the Sustainable Development Goals. The book is of vital interest to academics, action researchers and funders, policy makers and civil-society organisations working on transformations to sustainability.

BACKGROUND: Stent thrombosis (ST) is a serious complication following coronary stenting. Intravascular optical coherence tomography (OCT) may provide insights into mechanistic processes leading to ST. We performed a prospective, multicenter study to evaluate OCT findings in patients with ST. METHODS: Consecutive patients presenting with ST were prospectively enrolled in a registry by using a centralized telephone registration system. After angiographic confirmation of ST, OCT imaging of the culprit vessel was performed with frequency domain OCT. Clinical data were collected according to a standardized protocol. OCT acquisitions were analyzed at a core laboratory. Dominant and contributing findings were adjudicated by an imaging adjudication committee. RESULTS: Two hundred thirty-one patients presenting with ST underwent OCT imaging; 14 (6.1%) had image quality precluding further analysis. Of the remaining patients, 62 (28.6%) and 155 (71.4%) presented with early and late/very late ST, respectively. The underlying stent type was a new-generation drug-eluting stent in 50.3%. Mean reference vessel diameter was 2.9+/-0.6 mm and mean reference vessel area was 6.8+/-2.6 mm(2). Stent underexpansion (stent expansion index <0.8) was observed in 44.4% of patients. The predicted average probability (95% confidence interval) that any frame had uncovered (or thrombus-covered) struts was 99.3% (96.1-99.9), 96.6% (92.4-98.5), 34.3% (15.0-60.7), and 9.6% (6.2-14.5) and malapposed struts was 21.8% (8.4-45.6), 8.5% (4.6-15.3), 6.7% (2.5-16.3), and 2.0% (1.2-3.3) for acute, subacute, late, and very late ST, respectively. The most common dominant finding adjudicated for acute ST was uncovered struts (66.7% of cases); for subacute ST, the most common dominant finding was uncovered struts (61.7%) and underexpansion (25.5%); for late ST, the most common dominant finding was uncovered struts (33.3%) and severe restenosis (19.1%); and for very late ST, the most common dominant finding was neoatherosclerosis (31.3%) and uncovered struts (20.2%). In patients presenting very late ST, uncovered stent struts were a common dominant finding in drug-eluting stents, and neoatherosclerosis was a common dominant finding in bare metal stents. CONCLUSIONS: In patients with ST, uncovered and malapposed struts were frequently observed with the incidence of both decreasing with longer time intervals between stent implantation and presentation. The most frequent dominant observation varied according to time intervals from index stenting: uncovered struts and underexpansion in acute/subacute ST and neoatherosclerosis and uncovered struts in late/very late ST. ; The research leading to these results has received funding from the European Union Seventh Framework Program FP7/2007 to 2013 under grant agreement HEALTH-F2-2010 to 260309 (PRESTIGE). Funding for open access publication is provided by the European Commission.

Background: Stent thrombosis (ST) is a serious complication following coronary stenting. Intravascular optical coherence tomography (OCT) may provide insights into mechanistic processes leading to ST. We performed a prospective, multicenter study to evaluate OCT findings in patients with ST. Methods: Consecutive patients presenting with ST were prospectively enrolled in a registry by using a centralized telephone registration system. After angiographic confirmation of ST, OCT imaging of the culprit vessel was performed with frequency domain OCT. Clinical data were collected according to a standardized protocol. OCT acquisitions were analyzed at a core laboratory. Dominant and contributing findings were adjudicated by an imaging adjudication committee. Results: Two hundred thirty-one patients presenting with ST underwent OCT imaging; 14 (6.1%) had image quality precluding further analysis. Of the remaining patients, 62 (28.6%) and 155 (71.4%) presented with early and late/very late ST, respectively. The underlying stent type was a newgeneration drug-eluting stent in 50.3%. Mean reference vessel diameter was 2.9±0.6 mm and mean reference vessel area was 6.8±2.6 mm 2 . Stent underexpansion (stent expansion index < 0.8) was observed in 44.4% of patients. The predicted average probability (95% confidence interval) that any frame had uncovered (or thrombus-covered) struts was 99.3% (96.1-99.9), 96.6% (92.4-98.5), 34.3% (15.0-60.7), and 9.6% (6.2-14.5) and malapposed struts was 21.8% (8.4-45.6), 8.5% (4.6-15.3), 6.7% (2.5-16.3), and 2.0% (1.2-3.3) for acute, subacute, late, and very late ST, respectively. The most common dominant finding adjudicated for acute ST was uncovered struts (66.7% of cases); for subacute ST, the most common dominant finding was uncovered struts (61.7%) and underexpansion (25.5%); for late ST, the most common dominant finding was uncovered struts (33.3%) and severe restenosis (19.1%); and for very late ST, the most common dominant finding was neoatherosclerosis (31.3%) and uncovered struts (20.2%). In patients presenting very late ST, uncovered stent struts were a common dominant finding in drug-eluting stents, and neoatherosclerosis was a common dominant finding in bare metal stents. Conclusions: In patients with ST, uncovered and malapposed struts were frequently observed with the incidence of both decreasing with longer time intervals between stent implantation and presentation. The most frequent dominant observation varied according to time intervals from index stenting: uncovered struts and underexpansion in acute/subacute ST and neoatherosclerosis and uncovered struts in late/very late ST ; Funding: The research leading to these results has received funding from the European Union Seventh Framework Programme FP7/2007-2013 under grant agreement n° HEALTH-F2-2010-260309 (PRESTIGE). Funding for open access publication is provided by the European Commission