title: Trust in and Ethical Design of Carebots: The Case for Ethics of Care

text: The paper has two main objectives: to examine the challenges arising from the use of carebots as well as to discuss how the design of carebots can deal with these challenges. First, it notes that the use of carebots to take care of the physical and mental health of the elderly, children and the disabled as well as to serve as assistive tools and social companions encounter a few main challenges. They relate to the extent of the care robots’ ability to care for humans, potential deception by robot morphology and communications, (over)reliance on or attachment to robots, and the risks of carebot use without informed consent and potential infringements of privacy. Secondly, these challenges impinge upon issues of ethics and trust which are somewhat overlapping in terms of concept and practice. The existing ethical guidelines, standards and regulations are general in nature and lack a central ethical framework and concrete principles applicable to the care contexts. Hence, to deal with these important challenges, it is proposed in the third part of the paper that carebots be designed by taking account of Ethics of Care as the central ethical framework. It argues that the Ethics of Care offer the following advantages: (a) it provides sufficiently concrete principles and embodies values that are sensitive and applicable to the design of carebots and the contexts of caring practices; (b) it coheres with the tenets of Principlism and select ethical theories (utilitarianism, deontology and virtue ethics); and (c) it is closely associated with the preservation and maintenance of trust.


title: Understanding Nativist Populism

text: This chapter discusses the main contribution of this study, which is in separating nativist populism from other kinds within the populist family. The convergence of nativism and populism has turned into a separate Neo-Nationalism spreading across Europe and America. In mapping their historical evolution through three waves and identifying common qualities, the book provides context for studying the rise of nativist populists. This chapter lays out how Neo-Nationalism of contemporary nativist populists should be understood. It identifies a winning formula of nativist populists, the dual process of instating fear and scapegoating. The chapter discusses discursive manipulations and structural inequities in the rhetoric of contemporary nativist populists. The surge of populist politics examined in this book has brought back the importance of dialectic observation, examining populism as countering mainstream politics. Another contribution here is in identifying a threefold claim which nativist populists put forth in their support of the people.


title: The Second Wave: The Collapse of Communism and 9/11

text: This chapter examines the second wave of nativist populism in the post-war era, which grew out of resentment in Western Europe against workers from the Eastern regions of the continent flocking over the former Iron Curtain after the collapse of the Berlin Wall in 1989. A spike within this wave occurred in the wake of the terrorist attacks in the US on 11 September 2001. The nature of the nationalism introduced in the second wave was somewhat different to that of the previously discussed agrarian populism or the anti-tax neo-liberal populism in the early 1970s. Rather than primarily referring to the social-economic situation of the ordinary people the emphasis moved over to a socio-cultural notion of our people. Although xenophobia and ethno-nationalism was surely a significant part of the populist message from the outset that sort of rhetoric rose much more clearly to the forefront in the second wave.


title: Conclusions: The Neo-Nationalist Order

text: This closing chapter traces the progression of nativist populism over these three waves, constituting a rise of contemporary Neo-Nationalism, which largely is defining our times. This trend culminated when three torrents coincided at a common confluence, fusing into a single channel of much greater velocity: the surge of populist politics, the spread of conspiracy theories and the avalanche of misinformation boosted by changes in the media. Nativist populist leaders in the new digital media environment were able to spread conspiracy theories and misinformation much further than before, crafting an especially successful recipe for undermining the political establishment. In essence, this book provides a broad overview of modern political history in Europe and in America. It covers some of the most contested phenomena in contemporary politics, focusing on nationalism, populism and right-wing extremism. Perhaps most vitally the book documents a turn away from liberal democracy established in the post-war era, and towards more authoritative illiberal modes of democracy.


title: The Third Wave: The International Financial Crisis and Refugees

text: This chapter examines the third wave of nativist populism in the post-war era, which began to brew in the wake of the International Financial Crisis starting in 2008. A fundamental shift occurred in the third wave with the Refugee Crisis heightening in 2015. Nativist populism spread further into the mainstream in European and American politics than ever before, for instance bringing Brexit to the UK, Donald Trump to power in America and Marine Le Pen qualifying to the second round in the presidential elections in France. Indeed, this was a brand-new world. The four largest democracies in the world—Brazil, Indonesia and India in addition to the US—were all governed by politicians often labelled as being populist. With the Coronavirus Crisis of 2020 nationalist sentiments were hightening again. Whichever way we attempt to slice this trend, the third wave brought a fundamental shift in the evolution of nativist populism and came to constitute a clear trend of Neo-Nationalism spreading across Europe, America and elsewhere.


title: Introduction: The Rise of Nativist Populism

text: The book offers a novel way of framing three waves of nativist populism in the post-war era, each examined in separate chapter. Each wave occurred in the wake of crisis or major social change, and each grew stronger than the one before. All are identifiable by their own qualities and characteristics, which here are analysed. The first wave arose in the wake of the Oil Crisis of the early 1970s and the second after the collapse of communism. The third wave rose most clearly in opposition to migration—mainly against Muslims settling in the West. This introductory chapter sets the stage for the study at hand, which is to map the rebirth of nationalism in Europe and America since the Second World War, which has taken on a populist form. The chapter lays the foundation for the book’s main investigation into how contemporary nativist populism has travelled in waves, and risen on the canopies of crises.


title: Lung and Pleura

text: Disorders of the lungs and pleura are common in children and are a frequent indication for medical imaging. Over the past decade, a combination of advances in MR imaging scanner technology and increased concern about the effects of ionizing radiation has led to increased utilization of MR imaging in the pediatric population. Despite this general trend, there has been slower adoption of MR imaging to evaluate the lungs and pleura due to technical limitations including motion artifact, low signal-to-noise ratios, and signal dephasing at air-tissue interfaces. As MR imaging technology advances, many of these technical hurdles are being overcome, and MR imaging of the lungs and pleura has begun to be a feasible option for many pediatric pleuropulmonary conditions. Therefore, an up-to-date understanding of these emerging applications is important to practitioners performing MR imaging in infants and children. In this chapter, an overview of MR imaging techniques to evaluate the lungs and pleura in children is discussed. Normal anatomy and development of the lungs and pleura are described, and the MR imaging findings in a spectrum pediatric lung and pleural disease are illustrated.


title: Bacillus subtilis spores as adjuvants against avian influenza H9N2 induce antigen-specific antibody and T cell responses in White Leghorn chickens

text: Low-pathogenicity avian influenza H9N2 remains an endemic disease worldwide despite continuous vaccination, indicating the need for an improved vaccine strategy. Bacillus subtilis (B. subtilis), a gram-positive and endospore-forming bacterium, is a non-pathogenic species that has been used in probiotic formulations for both animals and humans. The objective of the present study was to elucidate the effect of B. subtilis spores as adjuvants in chickens administered inactivated avian influenza virus H9N2. Herein, the adjuvanticity of B. subtilis spores in chickens was demonstrated by enhancement of H9N2 virus-specific IgG responses. B. subtilis spores enhanced the proportion of B cells and the innate cell population in splenocytes from chickens administered both inactivated H9N2 and B. subtilis spores (Spore + H9N2). Furthermore, the H9N2 and spore administration induced significantly increased expression of the pro-inflammatory cytokines IL-1β and IL-6 compared to that in the H9N2 only group. Additionally, total splenocytes from chickens immunized with inactivated H9N2 in the presence or absence of B. subtilis spores were re-stimulated with inactivated H9N2. The subsequent results showed that the extent of antigen-specific CD4(+) and CD8(+) T cell proliferation was higher in the Spore + H9N2 group than in the group administered only H9N2. Taken together, these data demonstrate that B. subtilis spores, as adjuvants, enhance not only H9N2 virus-specific IgG but also CD4(+) and CD8(+) T cell responses, with an increase in pro-inflammatory cytokine production. This approach to vaccination with inactivated H9N2 together with a B. subtilis spore adjuvant in chickens produces a significant effect on antigen-specific antibody and T cell responses against avian influenza virus.


title: Effect of mechanical power on intensive care mortality in ARDS patients

text: BACKGROUND: In ARDS patients, mechanical ventilation should minimize ventilator-induced lung injury. The mechanical power which is the energy per unit time released to the respiratory system according to the applied tidal volume, PEEP, respiratory rate, and flow should reflect the ventilator-induced lung injury. However, similar levels of mechanical power applied in different lung sizes could be associated to different effects. The aim of this study was to assess the role both of the mechanical power and of the transpulmonary mechanical power, normalized to predicted body weight, respiratory system compliance, lung volume, and amount of aerated tissue on intensive care mortality. METHODS: Retrospective analysis of ARDS patients previously enrolled in seven published studies. All patients were sedated, paralyzed, and mechanically ventilated. After 20 min from a recruitment maneuver, partitioned respiratory mechanics measurements and blood gas analyses were performed with a PEEP of 5 cmH(2)O while the remaining setting was maintained unchanged from the baseline. A whole lung CT scan at 5 cmH(2)O of PEEP was performed to estimate the lung gas volume and the amount of well-inflated tissue. Univariate and multivariable Poisson regression models with robust standard error were used to calculate risk ratios and 95% confidence intervals of ICU mortality. RESULTS: Two hundred twenty-two ARDS patients were included; 88 (40%) died in ICU. Mechanical power was not different between survivors and non-survivors 14.97 [11.51–18.44] vs. 15.46 [12.33–21.45] J/min and did not affect intensive care mortality. The multivariable robust regression models showed that the mechanical power normalized to well-inflated tissue (RR 2.69 [95% CI 1.10–6.56], p = 0.029) and the mechanical power normalized to respiratory system compliance (RR 1.79 [95% CI 1.16–2.76], p = 0.008) were independently associated with intensive care mortality after adjusting for age, SAPS II, and ARDS severity. Also, transpulmonary mechanical power normalized to respiratory system compliance and to well-inflated tissue significantly increased intensive care mortality (RR 1.74 [1.11–2.70], p = 0.015; RR 3.01 [1.15–7.91], p = 0.025). CONCLUSIONS: In our ARDS population, there is not a causal relationship between the mechanical power itself and mortality, while mechanical power normalized to the compliance or to the amount of well-aerated tissue is independently associated to the intensive care mortality. Further studies are needed to confirm this data.


title: Biomarker-driven management strategies for peripheral T cell lymphoma

text: Peripheral T cell lymphomas are heterogeneous diseases which remain treatment challenges. Recent advances in molecular and genomic profiling have provided unprecedented insight into disease pathogenesis driven by distinct cells of origins and molecular pathways. The discovery and clinical application of molecular biomarkers in PTCL subtypes has the potential to transform personalized care for patients with PTCL in diagnosis, prognosis, and therapy. Targeting CD30+ PTCL with the antibody-drug conjugate brentuximab vedotin in the relapsed setting and in combination with chemotherapy in the frontline setting has improved patient survivals. Epigenetic modifying agents, including HDAC inhibitors and hypomethylating agents, have demonstrated broad clinical efficacy and durability and are in clinical development for combination strategies for both relapsed and frontline settings. Wide-ranging novel agents targeting critical intracellular pathways and tumor microenvironment are in active exploration to define clinical activities. This review summarizes PTCL-specific biomarkers which are increasingly incorporated in clinical practice to guide precision diagnosis and personalized treatment.


title: Underdiagnoses of Rickettsia in patients hospitalized with acute fever in Indonesia: observational study results

text: BACKGROUND: Reports of human rickettsial infection in Indonesia are limited. This study sought to characterize the epidemiology of human rickettsioses amongst patients hospitalized with fever at 8 tertiary hospitals in Indonesia. METHODS: Acute and convalescent blood from 975 hospitalized non-dengue patients was tested for Rickettsia IgM and IgG by ELISA. Specimens from cases with seroconversion or increasing IgM and/or IgG titers were tested for Rickettsia IgM and IgG by IFA and Rickettsia genomes using primers for Rickettsia (R.) sp, R. typhi, and Orientia tsutsugamushi. Testing was performed retrospectively on stored specimens; results did not inform patient management. RESULTS: R. typhi, R. rickettsii, and O. tsutsugamushi IgG antibodies were identified in 269/872 (30.8%), 36/634 (5.7%), and 19/504 (3.8%) of samples, respectively. For the 103/975 (10.6%) non-dengue patients diagnosed with acute rickettsial infection, presenting symptoms included nausea (72%), headache (69%), vomiting (43%), lethargy (33%), anorexia (32%), arthralgia (30%), myalgia (28%), chills (28%), epigastric pain (28%), and rash (17%). No acute rickettsioses cases were suspected during hospitalization. Discharge diagnoses included typhoid fever (44), dengue fever (20), respiratory infections (7), leptospirosis (6), unknown fever (6), sepsis (5), hepatobiliary infections (3), UTI (3), and others (9). Fatalities occurred in 7 (6.8%) patients, mostly with co-morbidities. CONCLUSIONS: Rickettsial infections are consistently misdiagnosed, often as leptospirosis, dengue, or Salmonella typhi infection. Clinicians should include rickettsioses in their differential diagnosis of fever to guide empiric management; laboratories should support evaluation for rickettsial etiologies; and public policy should be implemented to reduce burden of disease.


title: A systematic review of biomarkers multivariately associated with acute respiratory distress syndrome development and mortality

text: BACKGROUND: Heterogeneity of acute respiratory distress syndrome (ARDS) could be reduced by identification of biomarker-based phenotypes. The set of ARDS biomarkers to prospectively define these phenotypes remains to be established. OBJECTIVE: To provide an overview of the biomarkers that were multivariately associated with ARDS development or mortality. DATA SOURCES: We performed a systematic search in Embase, MEDLINE, Web of Science, Cochrane CENTRAL, and Google Scholar from inception until 6 March 2020. STUDY SELECTION: Studies assessing biomarkers for ARDS development in critically ill patients at risk for ARDS and mortality due to ARDS adjusted in multivariate analyses were included. DATA EXTRACTION AND SYNTHESIS: We included 35 studies for ARDS development (10,667 patients at risk for ARDS) and 53 for ARDS mortality (15,344 patients with ARDS). These studies were too heterogeneous to be used in a meta-analysis, as time until outcome and the variables used in the multivariate analyses varied widely between studies. After qualitative inspection, high plasma levels of angiopoeitin-2 and receptor for advanced glycation end products (RAGE) were associated with an increased risk of ARDS development. None of the biomarkers (plasma angiopoeitin-2, C-reactive protein, interleukin-8, RAGE, surfactant protein D, and Von Willebrand factor) was clearly associated with mortality. CONCLUSIONS: Biomarker data reporting and variables used in multivariate analyses differed greatly between studies. Angiopoeitin-2 and RAGE in plasma were positively associated with increased risk of ARDS development. None of the biomarkers independently predicted mortality. Therefore, we suggested to structurally investigate a combination of biomarkers and clinical parameters in order to find more homogeneous ARDS phenotypes. PROSPERO IDENTIFIER: PROSPERO, CRD42017078957


title: Use, timing and factors associated with tracheal intubation in septic shock: a prospective multicentric observational study

text: BACKGROUND: No recommendation exists about the timing and setting for tracheal intubation and mechanical ventilation in septic shock. PATIENTS AND METHODS: This prospective multicenter observational study was conducted in 30 ICUs in France and Spain. All consecutive patients presenting with septic shock were eligible. The use of tracheal intubation was described across the participating ICUs. A multivariate analysis was performed to identify parameters associated with early intubation (before H8 following vasopressor onset). RESULTS: Eight hundred and fifty-nine patients were enrolled. Two hundred and nine patients were intubated early (24%, range 4.5–47%), across the 18 centers with at least 20 patients included. The cumulative intubation rate during the ICU stay was 324/859 (38%, range 14–65%). In the multivariate analysis, seven parameters were significantly associated with early intubation and ranked as follows by decreasing weight: Glasgow score, center effect, use of accessory respiratory muscles, lactate level, vasopressor dose, pH and inability to clear tracheal secretions. Global R-square of the model was only 60% indicating that 40% of the variability of the intubation process was related to other parameters than those entered in this analysis. CONCLUSION: Neurological, respiratory and hemodynamic parameters only partially explained the use of tracheal intubation in septic shock patients. Center effect was important. Finally, a vast part of the variability of intubation remained unexplained by patient characteristics. Trial registration Clinical trials NCT02780466, registered on May 23, 2016. https://clinicaltrials.gov/ct2/show/NCT02780466?term=intubatic&draw=2&rank=1.


title: Systematic identification of chicken type I, II and III interferon-stimulated genes

text: Interferon-stimulated genes (ISGs) play an important role in antiviral innate immune responses. Although many ISGs have been identified in mammals, researchers commonly recognize that many more ISGs are yet to be discovered. Current information is still very limited particularly for the systematic identification of type III ISGs. Similarly, current research on ISGs in birds is still in its infancy. The aim of this study was to systematically identify chicken type I (IFN-α), II (IFN-γ) and III (IFN-λ) ISGs and analyze their respective response elements. RNA sequencing (RNA-Seq) was employed to identify those genes with up-regulated expression following chicken IFN-α, IFN-γ and IFN-λ treatment. Two hundred and five type I ISGs, 299 type II ISGs, and 421 type III ISGs were identified in the chicken. We further searched for IFN-stimulated response elements (ISRE) and gamma-activated sequences (GAS) elements in the promoters region of ISGs. The GAS elements were common in the promoter of type II ISGs and were even detected in type I and III ISGs. However, ISRE were not commonly found in the promoters of chicken ISGs. Furthermore, we demonstrated that ISRE in chicken cells were significantly activated by IFN-α or IFN-λ treatment, and expectedly, that GAS elements were also significantly activated by IFN-γ treatment. Interestingly, we also found that GAS elements were significantly activated by IFN-λ. Our study provides a systematic library of ISGs in the chicken together with preliminary information about the transcriptional regulation of the identified ISGs.


title: Recovery during a crisis: facing the challenges of risk assessment and resilience management of COVID-19

text: The paper offers a disaster risk management perspective to analyze the COVID-19 pandemic and to propose and assess non-pharmaceutical mitigation measures for the recovery phase. Three main aspects are tackled: (i) the need to take a scenario-based approach; (i) the need to propose more fine-tuned and context-sensitive mitigation measures, the effectiveness and the cost–benefit of which must be carefully appraised; (iii) better communication as a fundamental pillar of any mitigation measure. Evidence and ideas from the field of natural disasters and man-made technological incidents are applied to tackle the health risk posed by the SARS-COV 2 virus and its rapid spread according to a multi-disciplinary perspective that addresses the health-related challenges and the need to avoid societal and economic breakdown.


title: Mechanism, frequency, transfusion and outcome of severe trauma in coagulopathic paediatric patients

text: PURPOSE: Acute traumatic coagulopathy can result in uncontrolled haemorrhage responsible for the majority of early deaths after adult trauma. Data on the frequency, transfusion practice and outcome of severe trauma haemorrhage in paediatric patients are inconsistent. METHODS: Datasets from paediatric trauma patients were retrieved from the registry of the German trauma society (TR-DGU(®)) between 2009 and 2016. Coagulopathy was defined by a Quick’s value < 70% (INR (international normalized ratio) > 1.4) and/or thrombocytes ≤ 100 k upon emergency room admission. Children were grouped according to age in 4 different groups (A: 1–5, B: 6–10, C: 11–15 and D: 16–17 years). Prevalence of coagulopathy was assessed. Demographics, injury severity, haemostatic management including transfusions and mortality were described. RESULTS: 5351 primary admitted children ≤ 17 years with an abbreviated injury scale (AIS) ≥ 3 and complete datasets were included. The prevalence of coagulopathy was 13.7% (733/5351). The majority of the children sustained blunt trauma (more than 90% independent of age group) and a combination of traumatic brain injury (TBI) and any other trauma in more than 60% (A, C, D) and in 53.8% in group B. Coagulopathy occurred the most among the youngest (A: 18.2%), followed by all other age groups with approximately 13%. Overall mortality was the highest in the youngest (A: 40.9%) and among the youngest patients with traumatic brain injury (A: 71.4% and B: 47.1%). Transfusion of packed red blood cells (pRBCs) and fresh frozen plasma (FFPs) occurred almost in a 2:1 ratio (or less) across all age subgroups. CONCLUSION: Traumatic haemorrhage in association with coagulopathy and severe shock is a major challenge in paediatric trauma across all age groups. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00068-020-01398-x) contains supplementary material, which is available to authorized users.


title: Clinical outcomes of extracorporeal membrane oxygenation in acute traumatic lung injury: a retrospective study

text: BACKGROUND: Therapeutic extracorporeal membrane oxygenation (ECMO) is a challenging procedure in patients who have experienced severe trauma. Particularly, patients with traumatic lung injury and posttraumatic acute respiratory distress syndrome (ARDS) have a high risk of bleeding during this procedure. This study aimed to determine the safety and feasibility of ECMO in patients with traumatic ARDS. METHODS: We retrospectively reviewed medical records and investigated the clinical outcomes of ECMO in 42 patients with traumatic ARDS, among whom near-drowning (42.9%) was the most frequent cause of injury. RESULTS: Thirty-four of 42 patients (81%) survived and were discharged after a median hospital stay of 23 days. A multivariate analysis identified a lactate level (odds ratio: 1.493, 95% confidence interval: 1.060–2.103, P = 0.022) and veno-venous (VV) ECMO (odds ratio: 0.075, 95% confidence interval: 0.006–0.901, P = 0.041) as favorable independent predictors of survival in patients with traumatic ARDS who underwent ECMO. The optimal cut off value for pre-ECMO lactate level was 10.5 mmol/L (area under the curve = 0.929, P = 0.001). In Kaplan-Meier analysis, the survival rate at hospital discharge was significant higher among the patients with a pre-ECMO lactate level of 10.5 mmol/L or less compared with patients with pre-ECMO lactate level greater than 10.5 mmol/L (93.8% versus 40.0%, respectively; P = 0.01). CONCLUSIONS: ECMO yielded excellent survival outcomes, particularly in patients with low pre-treatment lactate levels who received VV ECMO. Therefore, ECMO appears safe and highly feasible in a carefully selected population of trauma patients.


title: The impact of health literacy environment on patient stress: a systematic review

text: BACKGROUND: There exists little literature on situational health literacy - that is, how an individual’s health literacy varies across different health literacy environments. However, one can consider the role of stress when examining the relationship between health situations and decision-making ability, and by proxy health literacy. The aim of this study was to assess the strength of the evidence on the relationship between health situations and patient stress, considered in the context of health professional perception, and determine what health situations act to influence patient stress. METHODS: A systematic review of English articles using PubMed, PsycINFO, CINAHL and Embase databases was conducted. Search terms focused on ‘patient’, ‘stress’, and ‘health care situations’. Only peer-reviewed original research with data on patient stress in the context of a health facility environment was included. Studies were screened and critically appraised by both authors. Study elements for extraction were defined by RO and extracted by JY. RESULTS: Twenty-four studies were included for narrative synthesis. Patients in Intensive Care Units were more stressed about factors relating to their physical discomfort, with some agreement from health care professionals. Parents of children in Intensive Care Units were more concerned with stressors relating to their child’s appearance and behaviour, and alteration in their parental role. Few studies examined health settings other than Intensive Care Units, and those that did varied greatly in terms of study design and population characteristics, lacking generalisability. CONCLUSIONS: Overall, the findings of what patients find most stressful in Intensive Care Units can guide health care professionals practicing best practice care. However, the evidence on how patient stress is influenced by non-Intensive Care Unit health care settings is weak. Further research is needed to enhance current understanding of the interaction between patient stress and health care environments in both hospital and primary care settings.


title: Early diagnosis and appropriate respiratory support for Mycoplasma pneumoniae pneumonia associated acute respiratory distress syndrome in young and adult patients: a case series from two centers

text: BACKGROUND: Mycoplasma pneumoniae (M. pneumoniae) is one of the most common causes of community acquired pneumonia (CAP). Establishing an early diagnosis of M. pneumoniae pneumonia in patients with acute respiratory distress syndrome (ARDS) may have important therapeutic implications. METHODS: We describe diagnosis and management of M. pneumoniae pneumonia induced ARDS in a case series of adults and youth hospitalized with radiographically confirmed CAP prospectively enrolled in an observational cohort study in two university teaching hospitals, from November 2017 to October 2019. RESULTS: In all 10 patients, early and rapid diagnosis for severe M. pneumoniae pneumonia with ARDS was achieved with polymerase chain reaction (PCR) or metagenomic next-generation sequencing (mNGS) testing of samples from the lower respiratory tract or pleural effusion. The average PaO(2)/FiO(2) of all patients was 180 mmHg. Of the 10 cases, 4 cases had moderate ARDS (100 mmHg ≤ PaO(2)/FiO(2) < 200 mmHg) and 3 cases had severe ARDS (PaO(2)/FiO(2) < 100 mmHg). High flow nasal cannula (HFNC) was applied in all patients, though only two patients were sufficiently supported with HFNC. Invasive mechanical ventilation (IMV) was required in 5 patients. High resistance (median 15 L/cmH(2)O/s) and low compliance (median 38 ml/cmH(2)O) was observed in 4 cases. In these 4 cases, recruitment maneuvers (RM) were applied, with 1 patient demonstrating no response to RM. Prone positioning were applied in 4 cases. Two cases needed ECMO support with median support duration of 5.5 days. No patient in our case series received corticosteroid therapy. All patients were survived and were discharged from hospital. CONCLUSIONS: Early and rapid diagnosis of severe M. pneumoniae pneumonia with ARDS can be achieved with PCR/mNGS tests in samples from the lower respiratory tract or pleural effusion. In our case series, half of M. pneumoniae pneumonia induced ARDS cases were adequately supported with HFNC or NIV, while half of cases required intubation. RM and prone position were effective in 30% of intubated cases, and 20% needed ECMO support. When early anti-mycoplasmal antibiotics were given together with sufficient respiratory support, the survival rate was high with no need for corticosteroid use.


title: Neuromuscular blockade management in the critically Ill patient

text: Neuromuscular blocking agents (NMBAs) can be an effective modality to address challenges that arise daily in the intensive care unit (ICU). These medications are often used to optimize mechanical ventilation, facilitate endotracheal intubation, stop overt shivering during therapeutic hypothermia following cardiac arrest, and may have a role in the management of life-threatening conditions such as elevated intracranial pressure and status asthmaticus (when deep sedation fails or is not tolerated). However, current NMBA use has decreased during the last decade due to concerns of potential adverse effects such as venous thrombosis, patient awareness during paralysis, development of critical illness myopathy, autonomic interactions, and even residual paralysis following cessation of NMBA use. It is therefore essential for clinicians to be familiar with evidence-based practices regarding appropriate NMBA use in order to select appropriate indications for their use and avoid complications. We believe that selecting the right NMBA, administering concomitant sedation and analgesic therapy, and using appropriate monitoring techniques mitigate these risks for critically ill patients. Therefore, we review the indications of NMBA use in the critical care setting and discuss the most appropriate use of NMBAs in the intensive care setting based on their structure, mechanism of action, side effects, and recognized clinical indications. Lastly, we highlight the available pharmacologic antagonists, strategies for sedation, newer neuromuscular monitoring techniques, and potential complications related to the use of NMBAs in the ICU setting.


title: Characteristics of pediatric adverse drug reaction reports in the Japanese Adverse Drug Event Report Database

text: BACKGROUND: There are no reports on investigations of the characteristics of adverse drug reaction (ADR) reports for pediatric patients in the Japanese Adverse Drug Event Report database (JADER) and the utility of database for drug safety surveillance in these patients. METHOD: We aimed to evaluate ADR reports for pediatric patients in the JADER. We used spontaneous ADR reports included in the JADER since April 1, 2004, to December 31, 2017, which was downloaded in April 2018. In a total of 504,407 ADR reports, the number of spontaneous reports was 386,400 (76.6%), in which 37,534 (7.4%) were unknown age reports. After extraction of 27,800 ADR reports for children aged < 10 and 10–19 years, we excepted for ADR reports associated with a vaccine (n = 6355) and no-suspected drug reports (n = 86). A total of 21,359 (4.2%) reports were finally included in this analysis. RESULTS: More than half of the ADR reports were for children aged < 10 years. Approximately 30% of ADR reports had multiple suspected drugs, which did not differ by age. The percentages of fatal outcomes of ADRs among patients aged < 10 and 10–19 years were 4.7 and 3.9%, respectively. The most frequently reported drug, reaction, and drug-reaction pair were oseltamivir, abnormal behavior, and oseltamivir and abnormal behavior, respectively. CONCLUSION: We clarified the characteristics of ADR reports for Japanese children by using the JADER. ADR report databases, especially those for pediatric patients, are valuable pharmacovigilance tools in Japan and other countries. Therefore, a proper understanding of the characteristics of the ADR reports in the JADER is important. Additionally, potential signals for ADRs in pediatric patients should be monitored continuously and carefully.


title: Possible advantages of early stabilization of spinal fractures in multiply injured patients with leading thoracic trauma - analysis based on the TraumaRegister DGU®

text: BACKGROUND: Major trauma often comprises fractures of the thoracolumbar spine and these are often accompanied by relevant thoracic trauma. Major complications can be ascribed to substantial simultaneous trauma to the chest and concomitant immobilization due to spinal instability, pain or neurological dysfunction, impairing the respiratory system individually and together. Thus, we proposed that an early stabilization of thoracolumbar spine fractures will result in significant benefits regarding respiratory organ function, multiple organ failure and length of ICU / hospital stay. METHODS: Patients documented in the TraumaRegister DGU®, aged ≥16 years, ISS ≥ 16, AIS(Thorax) ≥ 3 with a concomitant thoracic and / or lumbar spine injury severity (AIS(Spine)) ≥ 3 were analyzed. Penetrating injuries and severe injuries to head, abdomen or extremities (AIS ≥ 3) led to patient exclusion. Groups with fractures of the lumbar (LS) or thoracic spine (TS) were formed according to the severity of spinal trauma (AIS(spine)): AIS(LS) = 3, AIS(LS) = 4–5, AIS(TS) = 3 and AIS(TS) = 4–5, respectively. RESULTS: 1740 patients remained for analysis, with 1338 (76.9%) undergoing spinal surgery within their hospital stay. 976 (72.9%) had spine surgery within the first 72 h, 362 (27.1%) later on. Patients with injuries to the thoracic spine (AIS(TS) = 3) or lumbar spine (AIS(LS) = 3) significantly benefit from early surgical intervention concerning ventilation time (AIS(LS) = 3 only), ARDS, multiple organ failure, sepsis rate (AIS(TS) = 3 only), length of stay in the intensive care unit and length of hospital stay. In multiple injured patients with at least severe thoracic spine trauma (AIS(TS) ≥ 4) early surgery showed a significantly shorter ventilation time, decreased sepsis rate as well as shorter time spend in the ICU and in hospital. CONCLUSIONS: Multiply injured patients with at least serious thoracic trauma (AIS(Thorax) ≥ 3) and accompanying spine trauma can significantly benefit from early spine stabilization within the first 72 h after hospital admission. Based on the presented data, primary spine surgery within 72 h for fracture stabilization in multiply injured patients with leading thoracic trauma, especially in patients suffering from fractures of the thoracic spine, seems to be beneficial.


title: Suicidal ideation, psychopathology and associated factors among HIV-infected adults in Indonesia

text: BACKGROUND: Suicidal behavior is a prevalent psychiatric emergency in HIV-infected adults. Detection of suicidal ideation is important in planning early psychiatric intervention and optimizing HIV/AIDS management. Characterization of suicidal ideation among HIV-infected adults is crucial; however, practically there is no data in Indonesia, the country with the second largest burden of HIV/AIDS epidemic in Asia. This study aims to identify suicidal ideation and analyze the associated psychopathology and determining factors among HIV-infected adults in Indonesia. METHODS: An observational cross-sectional study was conducted among HIV-infected adults aged 18–65 years old receiving antiretroviral therapy (ART). Measurement using Symptom Checklist-90 (SCL-90) was performed to assess the existing psychopathology. Firth’s penalized logistic regression analysis was performed to identify factors associated with suicidal ideation. RESULTS: A total of 86 subjects were recruited. Most subjects were male (65.1%), median age was 35 years, and median latest CD4 count was 463 cells/μl. Lifetime suicidal ideation was identified in 20 subjects (23.3%). Mean SCL-90 T-score for depressive and anxiety symptoms were both significantly higher among subjects with suicidal ideation (M = 60.75, SD = 12.0, p = 0.000 and M = 57.9, SD = 2.8, p = 0.001, respectively) compared to those without. Bivariate analyses showed that lifetime suicidal ideation was associated with depressive and anxiety symptoms, non-marital status, CD4 count < 500 cells/μl, and efavirenz use. Multivariate analysis identified that a single-point increase in SCL-90 depression symptoms score (AOR 1.16, 95% CI 4.5–123.6, p = 0.000) and efavirenz use (AOR 5.00, 95% CI 1.02–24.6, p = 0.048) were significant independent factors related to suicidal ideation. CONCLUSION: Suicidal ideation is commonly found among Indonesian HIV-infected adults on ART. Depressive symptoms and efavirenz use are independent factors related to the presence of suicidal ideation. Thus, early screening of psychopathology as well as substitution of efavirenz with other ART regiment are recommended to prevent suicide and improve HIV/AIDS management outcome.


title: Perspective of placenta derived mesenchymal stem cells in acute liver failure

text: Acute Liver failure (ALF) is a life-threatening disease and is determined by coagulopathy (with INR ≥ 1.5) and hepatic encephalopathy as a result of severe liver injury in patients without preexisting liver disease. Since there are problems with liver transplantation including lack of donors, use of immunosuppressive drugs, and high costs of this process, new therapeutic approaches alongside current treatments are needed. The placenta is a tissue that is normally discarded after childbirth. On the other hand, human placenta is a rich source of mesenchymal stem cells (MSCs), which is easily available, without moral problems, and its derived cells are less affected by age and environmental factors. Therefore, placenta-derived mesenchymal stem cells (PD-MSCs) can be considered as an allogeneic source for liver disease. Considering the studies on MSCs and their effects on various diseases, it can be stated that MSCs are among the most important agents to be used for novel future therapies of liver diseases. In this paper, we will investigate the effects of mesenchymal stem cells through migration and immigration to the site of injury, cell-to-cell contact, immunomodulatory effects, and secretory factors in ALF.


title: Duration of prone position sessions: a prospective cohort study

text: BACKGROUND: Prone position (PP) is highly recommended in moderate-to-severe ARDS. However, the optimal duration of PP sessions remains unclear. We searched to evaluate the time required to obtain the maximum physiological effect, and to search for parameters related to patient survival in PP. METHODS AND RESULTS: It was a prospective, monocentric, physiological study. We included in the study all prone-positioned patients in our ICU between June 2016 and January 2018. Pulmonary mechanics, data from volumetric capnography and arterial blood gas were recorded before prone positioning, 2 h after proning, before return to a supine position (SP) and 2 h after return to SP. Dynamic parameters were recorded before proning and every 30 min during the session until 24 h. 103 patients (ARDS 95%) were included performing 231 PP sessions with a mean length of 21.5 ± 5 h per session. They presented a significant increase in pH, static compliance and P(a)O(2)/F(i)O(2) with a significant decrease in P(a)CO(2), P(plat), phase 3 slope of the volumetric capnography, P(et)CO(2), V(D)/V(T-phy) and ΔP. The beneficial physiological effects continued after 16 h of PP and at least up to 24 h in some patients. The evolution of the respiratory parameters during the first session and also during the pooled sessions did not find any predictor of response to PP, whether before, during or 2 h after the return in SP. CONCLUSIONS: PP sessions should be prolonged at least 24 h and be extended in the event that the P(a)O(2)/F(i)O(2) ratio at 24 h remains below 150, especially since no criteria can predict which patient will benefit or not from it. Trial registration The trial has been registered on 28 June 2016 in ClinicalTrials.gov (NCT 02816190) (https://clinicaltrials.gov/ct2/show/NCT02816190?term=propocap&rank=1).


title: Intravenous fluid therapy in the perioperative and critical care setting: Executive summary of the International Fluid Academy (IFA)

text: Intravenous fluid administration should be considered as any other pharmacological prescription. There are three main indications: resuscitation, replacement, and maintenance. Moreover, the impact of fluid administration as drug diluent or to preserve catheter patency, i.e., fluid creep, should also be considered. As for antibiotics, intravenous fluid administration should follow the four Ds: drug, dosing, duration, de-escalation. Among crystalloids, balanced solutions limit acid–base alterations and chloride load and should be preferred, as this likely prevents renal dysfunction. Among colloids, albumin, the only available natural colloid, may have beneficial effects. The last decade has seen growing interest in the potential harms related to fluid overloading. In the perioperative setting, appropriate fluid management that maintains adequate organ perfusion while limiting fluid administration should represent the standard of care. Protocols including a restrictive continuous fluid administration alongside bolus administration to achieve hemodynamic targets have been proposed. A similar approach should be considered also for critically ill patients, in whom increased endothelial permeability makes this strategy more relevant. Active de-escalation protocols may be necessary in a later phase. The R.O.S.E. conceptual model (Resuscitation, Optimization, Stabilization, Evacuation) summarizes accurately a dynamic approach to fluid therapy, maximizing benefits and minimizing harms. Even in specific categories of critically ill patients, i.e., with trauma or burns, fluid therapy should be carefully applied, considering the importance of their specific aims; maintaining peripheral oxygen delivery, while avoiding the consequences of fluid overload.


title: Discovery of anti-influenza nucleoside triphosphates targeting the catalytic site of A/PR/8/34/H1N1 polymerase

text: In an effort to develop potent anti-influenza drugs that inhibit the activity of influenza virus RNA-dependent RNA polymerase (IAV RdRp), a database of nucleoside triphosphates with ~800 molecules were docked with the homology model of IAV RdRp from A/PR/8/34/H1N1 strain. Out of top 12 molecules that bind with higher affinities to the catalytic site of IAV RdRp above and below the PB1 priming loop, only seven molecules decreased the transcriptional activity of the viral RNA polymerase with an IC(50) in the range of 0.09–3.58 µM. Molecular docking combining with experimental study indicated that the molecules with linear chain are more effective in inhibiting IAV RdRp replication than the molecules with V-shaped and are cyclic in nature. A correlation between ΔG and LogIC(50) for these seven compounds resulted an R(2) value of 0.73. Overall, these newly developed seven nucleoside triphosphates lay a strong foundation for the future development of a new therapeutics that can satisfy the Lipinski’s rule of five exhibiting high specificity to the catalytic site of influenza-A viruses.


title: Trauma patients with human immunodeficiency virus (HIV): a propensity matched analysis

text: BACKGROUND: Given the growing number of people worldwide living with huma immunodeficiency virus (HIV), a larger subset of these patients are now susceptible to sustaining a traumatic injury. However, the impact of HIV on outcomes in trauma with modern antiretroviral treatment remains unclear. We hypothesized mortality and rates of infectious and inflammatory complications would be higher in HIV positive (HIV+) trauma patients. METHODS: The Trauma Quality Improvement Program was queried to identify trauma patients ≥ 18 years of age with HIV. Due to the imbalance between HIV+ and HIV negative (HIV−) trauma patients, a 1:2 propensity-matched model was utilized. Matched variables included age, injury severity score, mechanism of injury, systolic blood pressure, pulse rate, Glasgow Coma Scale score, and patient comorbidities. RESULTS: 84 HIV+ patients were matched to 168 HIV− patients. Compared to HIV− patients, HIV+ patients had no significant differences in mortality rate (9.5% vs. 4.8%, p = 0.144) or infectious complications, including pneumonia (6.0% vs. 4.2%, p = 0.530), urinary tract infection (1.2% vs. 1.2%, p = 1.000), or severe sepsis (1.2% vs. 0.0%, p = 0.156). However, higher rates of acute respiratory distress syndrome (ARDS) (9.5% vs. 0.6%, p < 0.001) and acute kidney injury (AKI) (4.8% vs. 0.0%, p = 0.004) were observed. CONCLUSION: HIV+ trauma patients are not at higher risk of mortality or infectious complications, likely due to the advent and prevalence of combination antiretroviral therapy. However, HIV positivity appears to increase the risk of AKI and ARDS in trauma patients. Further research is needed to confirm this finding to elucidate the etiology underlying this association.


COVID-19: Joint Statement on Minimally Invasive Gynecologic Surgery


title: B1 protein: a novel cell penetrating protein for in vitro and in vivo delivery of HIV-1 multi-epitope DNA constructs

text: OBJECTIVES: Enhancement of the potential ability of biomacromolecules to cross cell membranes is a critical step for development of effective therapeutic vaccine especially DNA vaccine against human immunodeficiency virus-1 (HIV-1) infection. The supercharged proteins were known as powerful weapons for delivery of different types of cargoes such as DNA and protein. Hence, we applied B1 protein with + 43 net charges obtained from a single frameshift in the gene encoding enhanced green fluorescent protein (eGFP) for delivery of two multi-epitope DNA constructs (nef-vpu-gp160-p24 and nef-vif-gp160-p24) in vitro and in vivo for the first time. For this purpose, B1 protein was generated in bacterial expression system under native conditions, and used to interact with both DNA constructs. RESULTS: Our data indicated that B1 protein (~ 27 kDa) was able to form a stable nanoparticle (~ 80–110 nm) with both DNA constructs at nitrogen: phosphate (N: P) ratio of 1:1. Moreover, the transfection efficiency of B1 protein for DNA delivery into HEK-293T cell line indicated that the cellular uptake of nef-vif-gp160-p24 DNA/ B1 and nef-vpu-gp160-p24 DNA/ B1 nanoparticles was about 32–35% with lower intensity as compared to TurboFect commercial reagent. On the other hand, immunization of BALB/c mice with different modalities demonstrated that B1 protein could enhance the levels of antibody, IFN-gamma and Granzyme B eliciting potent and strong Th1-directed cellular immunity. CONCLUSION: Generally, our findings showed the potency of B1 protein as a promising gene delivery system to improve an effective therapeutic vaccine against HIV-1 infection.


title: Resuming elective surgical services in times of COVID-19 infection

text: The consequences of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus have been devastating to the healthcare system. As the positive effects of social distancing, mandatory masking, and societal lockdown on the spread of the disease and its incidence in the community were documented, societal and financial pressures mounted worldwide, prompting efforts to “re-open” countries, states, communities, businesses, and schools. The same happened with hospital, which had to start developing strategies to resume elective surgery activities. This manuscript describes the pre-requisites as well as the strategies for resuming surgical activity, be it in the outpatient or inpatient setting.


Ten minutes with Dr Gregory R Ciottone, MD, FACEP, FFSEM, President of the World Association for Disaster and Emergency Medicine


Vitamin D and SARS-CoV-2 virus/COVID-19 disease


A way towards ventilator-associated lower respiratory tract infection research


title: Establishment of Murine Infection Models with Biological Clones of Dengue Viruses Derived from a Single Clinical Viral Isolate

text: Dengue virus (DENV) is a single-stranded RNA virus transmitted by mosquitoes in tropical and subtropical regions. It causes dengue fever, dengue hemorrhagic fever and dengue shock syndrome in patients. Each year, 390 million people are estimated to be infected by four serotypes of dengue virus, creating a great burden on global public health and local economy. So far, no antiviral drug is available for dengue disease, and the newly licensed vaccine is far from satisfactory. One large obstacle for dengue vaccine and drug development is the lack of suitable small animal models. Although some DENV infection models have been developed, only a small number of viral strains can infect immunodeficient mice. In this study, with biologically cloned viruses from a single clinical isolate, we have established two mouse models of DENV infection, one is severe lethal infection in immunocompromised mice, and the other resembles self-limited disease manifestations in Balb/c mice with transient blockage of type I IFN responses. This study not only offers new small animal models of dengue viral infection, but also provides new viral variants for further investigations on dengue viral pathogenesis.


The attributable mortality of acute respiratory distress syndrome


title: Prognostic relevance and inter-observer reliability of chest-imaging in pediatric ARDS: a pediatric acute respiratory distress incidence and epidemiology (PARDIE) study

text: PURPOSE: Definitions of acute respiratory distress syndrome (ARDS) include radiographic criteria, but there are concerns about reliability and prognostic relevance. This study aimed to evaluate the independent relationship between chest imaging and mortality and examine the inter-rater variability of interpretations of chest radiographs (CXR) in pediatric ARDS (PARDS). METHODS: Prospective, international observational study in children meeting Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria for PARDS, which requires new infiltrate(s) consistent with pulmonary parenchymal disease, without mandating bilateral infiltrates. Mortality analysis focused on the entire cohort, whereas inter-observer variability used a subset of patients with blinded, simultaneous interpretation of CXRs by intensivists and radiologists. RESULTS: Bilateral infiltrates and four quadrants of alveolar consolidation were associated with mortality on a univariable basis, using CXRs from 708 patients with PARDS. For patients on either invasive (IMV) or non-invasive ventilation (NIV) with PaO(2)/FiO(2) (PF) ratios (or SpO(2)/FiO(2) (SF) ratio equivalent) > 100, neither bilateral infiltrates (OR 1.3 (95% CI 0.68, 2.5), p = 0.43), nor 4 quadrants of alveolar consolidation (OR 1.6 (0.85, 3), p = 0.14) were associated with mortality. For patients with PF ≤ 100, bilateral infiltrates (OR 3.6 (1.4, 9.4), p = 0.01) and four quadrants of consolidation (OR 2.0 (1.14, 3.5), p = 0.02) were associated with higher mortality. A subset of 702 CXRs from 233 patients had simultaneous interpretations. Interobserver agreement for bilateral infiltrates and quadrants was “slight” (kappa 0.31 and 0.33). Subgroup analysis showed agreement did not differ when stratified by PARDS severity but was slightly higher for children with chronic respiratory support (kappa 0.62), NIV at PARDS diagnosis (kappa 0.53), age > 10 years (kappa 0.43) and fluid balance > 40 ml/kg (kappa 0.48). CONCLUSION: Bilateral infiltrates and quadrants of alveolar consolidation are associated with mortality only for those with PF ratio ≤ 100, although there is high- inter-rater variability in these chest-x ray parameters. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00134-020-06074-7) contains supplementary material, which is available to authorized users.


ASNC’s efforts during the COVID-19 pandemic


title: Transverse colon perforation in the mediastinum after esophagectomy: a case report

text: BACKGROUND: While anastomotic leakage, recurrent laryngeal nerve paralysis, and pneumonia are well-known complications of esophagectomy, the incidence of hiatal hernia after esophagectomy for carcinoma has been reported to only be between 0.6 and 10%. We report a very rare case of hiatal hernia with transverse colon rupture in the mediastinum after esophagectomy in a 65-year-old woman. CASE PRESENTATION: The patient underwent definitive chemoradiotherapy for clinical stage IIA esophageal squamous cell carcinoma and salvage esophagectomy with gastric tube reconstruction through a posterior mediastinum route for residual carcinoma. Three years after the initial surgery, two metastatic nodules in the lateral and posterior segments of the liver were detected on follow-up CT and were treated with oral anticancer drugs. After 6 months, the patient was readmitted for anorexia. Upon admission, computed tomography revealed an ileus caused by a hiatal hernia. Emergent operative repair was performed; an incarcerated herniation of the transverse colon was perforated in the mediastinum, and partial transverse colon resection and colostomy were performed. Intensive care was required to control septic shock after surgery, and the patient was discharged on the 53rd postoperative day. CONCLUSIONS: Cases of hiatal hernia with digestive tract prolapsing into the mediastinum after esophagectomy with reconstruction through posterior mediastinum are rare but potentially life-threatening complications.


title: PD-1/PD-L1 Based Combinational Cancer Therapy: Icing on the Cake

text: Cancer has been a major global health problem due to its high morbidity and mortality. While many chemotherapy agents have been studied and applied in clinical trials or in clinic, their application is limited due to its toxic side effects and poor tolerability. Monoclonal antibodies specific to the PD-1 and PD-L1 immune checkpoints have been approved for the treatment of various tumors. However, the application of PD-1/PD-L1 inhibitors remains suboptimal and thus another strategy comes in to our sight involving the combination of checkpoint inhibitors with other agents, enhancing the therapeutic efficacy. Various novel promising approaches are now in clinical trials, just as icing on the cake. This review summarizes relevant investigations on combinatorial therapeutics based on PD-1/PD-L1 inhibition.


The COVIRL-001 Trial: A multicentre, prospective, randomised trial comparing standard of care (SOC) alone, SOC plus hydroxychloroquine monotherapy or SOC plus a combination of hydroxychloroquine and azithromycin in the treatment of non- critical, SARS-CoV-2 PCR-positive population not requiring immediate resuscitation or ventilation but who have evidence of clinical decline: A structured summary of a study protocol for a randomised controlled trial


American College of Cardiology: Leading Through Change, Moving the Profession Forward


title: Descriptional Complexity of Semi-simple Splicing Systems

text: Splicing systems are generative mechanisms introduced by Tom Head in 1987 to model the biological process of DNA recombination. The computational engine of a splicing system is the “splicing operation”, a cut-and-paste binary string operation defined by a set of “splicing rules”, quadruples [Formula: see text] where [Formula: see text] are words over an alphabet [Formula: see text]. For two strings [Formula: see text] and [Formula: see text], applying the splicing rule r produces the string [Formula: see text]. In this paper we focus on a particular type of splicing systems, called (i, j) semi-simple splicing systems, [Formula: see text] and [Formula: see text], wherein all splicing rules r have the property that the two strings in positions i and j in r are singleton letters, while the other two strings are empty. The language generated by such a system consists of the set of words that are obtained starting from an initial set called “axiom set”, by iteratively applying the splicing rules to strings in the axiom set as well as to intermediately produced strings. We consider semi-simple splicing systems where the axiom set is a regular language, and investigate the descriptional complexity of such systems in terms of the size of the minimal deterministic finite automata that recognize the languages they generate.


title: Computing the Shortest String and the Edit-Distance for Parsing Expression Languages

text: A distance between two languages is a useful tool to measure the language similarity, and is closely related to the intersection problem as well as the shortest string problem. A parsing expression grammar (PEG) is an unambiguous grammar such that the choice operator selects the first matching in PEG while it can be ambiguous in a context-free grammar. PEGs are also closely related to top-down parsing languages. We consider two problems on parsing expression languages (PELs). One is the r-shortest string problem that decides whether or not a given PEL contains a string of length shorter than r. The other problem is the edit-distance problem of PELs with respect to other language families such as finite languages or regular languages. We show that the r-shortest string problem and the edit-distance problem with respect to finite languages are NEXPTIME-complete, and the edit-distance problem with respect to regular languages is undecidable. In addition, we prove that it is impossible to compute a length bound [Formula: see text] of a PEG G such that L(G) has a string w of length at most [Formula: see text].


title: The State Complexity of Lexicographically Smallest Words and Computing Successors

text: Given a regular language L over an ordered alphabet [Formula: see text], the set of lexicographically smallest (resp., largest) words of each length is itself regular. Moreover, there exists an unambiguous finite-state transducer that, on a given word [Formula: see text], outputs the length-lexicographically smallest word larger than w (henceforth called the L-successor of w). In both cases, naïve constructions result in an exponential blowup in the number of states. We prove that if L is recognized by a DFA with n states, then [Formula: see text] states are sufficient for a DFA to recognize the subset S(L) of L composed of its lexicographically smallest words. We give a matching lower bound that holds even if S(L) is represented as an NFA. We then show that the same upper and lower bounds hold for an unambiguous finite-state transducer that computes L-successors.


title: Transition Property for [Formula: see text]-Power Free Languages with [Formula: see text] and [Formula: see text] Letters

text: In 1985, Restivo and Salemi presented a list of five problems concerning power free languages. Problem 4 states: Given [Formula: see text]-power-free words u and v, decide whether there is a transition from u to v. Problem 5 states: Given [Formula: see text]-power-free words u and v, find a transition word w, if it exists. Let [Formula: see text] denote an alphabet with k letters. Let [Formula: see text] denote the [Formula: see text]-power free language over the alphabet [Formula: see text], where [Formula: see text] is a rational number or a rational “number with [Formula: see text]”. If [Formula: see text] is a “number with [Formula: see text]” then suppose [Formula: see text] and [Formula: see text]. If [Formula: see text] is “only” a number then suppose [Formula: see text] and [Formula: see text] or [Formula: see text] and [Formula: see text]. We show that: If [Formula: see text] is a right extendable word in [Formula: see text] and [Formula: see text] is a left extendable word in [Formula: see text] then there is a (transition) word w such that [Formula: see text]. We also show a construction of the word w.


title: Avoidability of Additive Cubes over Alphabets of Four Numbers

text: Let [Formula: see text] be a set of size 4 such that [Formula: see text] cannot be obtained by applying the same affine function to all of the elements of [Formula: see text]. We show that there is an infinite sequence of elements of [Formula: see text] that contains no three consecutive blocks of same size and same sum (additive cubes). Moreover, it is possible to replace [Formula: see text] by [Formula: see text] in the statement.


title: Dynamics of Cellular Automata on Beta-Shifts and Direct Topological Factorizations

text: We consider the range of possible dynamics of cellular automata (CA) on two-sided beta-shifts [Formula: see text]. We show that any reversible CA [Formula: see text] has an almost equicontinuous direction whenever [Formula: see text] is not sofic. This has the corollary that non-sofic beta-shifts are topologically direct prime, i.e. they are not conjugate to direct topological factorizations [Formula: see text] of two nontrivial subshifts X and Y. We also make some preliminary observations on direct topological factorizations of beta-shifts that are subshifts of finite type.


title: On Tree Substitution Grammars

text: Tree substitution grammars are formal models that are used extensively in natural language processing. It is demonstrated that their expressive power is located strictly between the local tree grammars and the regular tree grammars. A decision procedure for the problem of determining whether a tree substitution grammar generates a local tree language is provided. Unfortunately, the class of tree substitution languages is neither closed under union, nor intersection, nor complements. Indeed unions of tree substitution languages even generate an infinite hierarchy. However, all finite and all co-finite tree languages are tree substitution languages.


title: Equivalence of Linear Tree Transducers with Output in the Free Group

text: We show that equivalence of deterministic linear tree transducers can be decided in polynomial time when their outputs are interpreted over the free group. Due to the cancellation properties offered by the free group, the required constructions are not only more general, but also simpler than the corresponding constructions for proving equivalence of deterministic linear tree-to-word transducers.


title: Scattered Factor-Universality of Words

text: A word [Formula: see text] is a scattered factor of a word w if u can be obtained from w by deleting some of its letters: there exist the (potentially empty) words [Formula: see text] such that [Formula: see text]. The set of all scattered factors up to length k of a word is called its full k-spectrum. Firstly, we show an algorithm deciding whether the k-spectra for given k of two words are equal or not, running in optimal time. Secondly, we consider a notion of scattered-factors universality: the word w, with [Formula: see text], is called k-universal if its k-spectrum includes all words of length k over the alphabet [Formula: see text]; we extend this notion to k-circular universality. After a series of preliminary combinatorial results, we present an algorithm computing, for a given [Formula: see text]-universal word w the minimal i such that [Formula: see text] is k-universal for some [Formula: see text]. Several other connected problems are also considered.


title: Operations on Permutation Automata

text: We investigate the class of languages recognized by permutation deterministic finite automata. Using automata constructions and some properties of permutation automata, we show that this class is closed under Boolean operations, reversal, and quotients, and it is not closed under concatenation, power, Kleene closure, positive closure, cut, shuffle, cyclic shift, and permutation. We prove that the state complexity of Boolean operations, Kleene closure, positive closure, and right quotient on permutation languages is the same as in the general case of regular languages. Next, we get the tight upper bounds on the state complexity of concatenation ([Formula: see text]), square ([Formula: see text]), reversal ([Formula: see text]), and left quotient ([Formula: see text]; tight if [Formula: see text]). All our witnesses are unary or binary, and the binary alphabet is always optimal, except for Boolean operations in the case of [Formula: see text]. In the unary case, the state complexity of all considered operations is the same as for regular languages, except for quotients and cut. In case of quotients, it is [Formula: see text], and in case of cut, it is either [Formula: see text] or [Formula: see text], depending on whether there exists an integer [Formula: see text] with [Formula: see text] such that [Formula: see text].


title: On the Fine Grained Complexity of Finite Automata Non-emptiness of Intersection

text: We study the fine grained complexity of the DFA non-emptiness of intersection problem parameterized by the number k of input automata (k -DFA-NEI). More specifically, we are given a list [Formula: see text] of DFA’s over a common alphabet [Formula: see text], and the goal is to determine whether [Formula: see text]. This problem can be solved in time [Formula: see text] by applying the classic Rabin-Scott product construction. In this work, we show that the existence of algorithms solving k -DFA-NEI in time slightly faster than [Formula: see text] would imply the existence of deterministic sub-exponential time algorithms for the simulation of nondeterministic linear space bounded computations. This consequence strengthens the existing conditional lower bounds for k-DFA-NEI and implies new non-uniform circuit lower bounds.


title: The Characterization of Rational Numbers Belonging to a Minimal Path in the Stern-Brocot Tree According to a Second Order Balancedness

text: In 1842, Dirichlet observed that any real number [Formula: see text] can be obtained as the limit of a sequence [Formula: see text] of irreducible rational numbers. Few years later, M. Stern (1858) and A. Brocot (1861) defined a tree-like arrangement of all the (irreducible) rational numbers whose infinite paths are the Dirichlet sequences of the real numbers and are characterized by their continued fraction representations. The Stern-Brocot tree is equivalent to the Christoffel tree obtained by ordering the Christoffel words according to their standard factorization. We remark that the Fibonacci word’s prefixes belong to a minimal path in the Christoffel tree with respect to the second order balancedness parameter defined on Christoffel words. This alows us to switch back to the Stern-Brocot tree, in order to give a characterization of the continued fraction representation for all the rational numbers belonging to minimal paths with respect to the growth of the second order balancedness.


title: Avoiding 5/4-Powers on the Alphabet of Nonnegative Integers (Extended Abstract)

text: We identify the structure of the lexicographically least word avoiding 5/4-powers on the alphabet of nonnegative integers.


title: Reconstructing Words from Right-Bounded-Block Words

text: A reconstruction problem of words from scattered factors asks for the minimal information, like multisets of scattered factors of a given length or the number of occurrences of scattered factors from a given set, necessary to uniquely determine a word. We show that a word [Formula: see text] can be reconstructed from the number of occurrences of at most [Formula: see text] scattered factors of the form [Formula: see text], where [Formula: see text] is the number of occurrences of the letter [Formula: see text] in w. Moreover, we generalize the result to alphabets of the form [Formula: see text] by showing that at most [Formula: see text] scattered factors suffices to reconstruct w. Both results improve on the upper bounds known so far. Complexity time bounds on reconstruction algorithms are also considered here.


title: Sublinear-Time Language Recognition and Decision by One-Dimensional Cellular Automata

text: After an apparent hiatus of roughly 30 years, we revisit a seemingly neglected subject in the theory of (one-dimensional) cellular automata: sublinear-time computation. The model considered is that of ACAs, which are language acceptors whose acceptance condition depends on the states of all cells in the automaton. We prove a time hierarchy theorem for sublinear-time ACA classes, analyze their intersection with the regular languages, and, finally, establish strict inclusions in the parallel computation classes [Formula: see text] and (uniform) [Formula: see text]. As an addendum, we introduce and investigate the concept of a decider ACA (DACA) as a candidate for a decider counterpart to (acceptor) ACAs. We show the class of languages decidable in constant time by DACAs equals the locally testable languages, and we also determine [Formula: see text] as the (tight) time complexity threshold for DACAs up to which no advantage compared to constant time is possible.


title: On the Degeneracy of Random Expressions Specified by Systems of Combinatorial Equations

text: We consider general expressions, which are trees whose nodes are labeled with operators, that represent syntactic descriptions of formulas. We assume that there is an operator that has an absorbing pattern and prove that if we use this property to simplify a uniform random expression with n nodes, then the expected size of the result is bounded by a constant. In our framework, expressions are defined using a combinatorial system, which describes how they are built: one can ensure, for instance, that there are no two consecutive stars in regular expressions. This generalizes a former result where only one equation was allowed, confirming the lack of expressivity of uniform random expressions.


title: An Approach to the Herzog-Schönheim Conjecture Using Automata

text: Let G be a group and [Formula: see text],..., [Formula: see text] be subgroups of G of indices [Formula: see text] respectively. In 1974, M. Herzog and J. Schönheim conjectured that if [Formula: see text], [Formula: see text], is a coset partition of G, then [Formula: see text] cannot be distinct. In this paper, we present a new approach to the Herzog-Schönheim conjecture based on automata and present a translation of the conjecture as a problem on automata.


title: A Study of a Simple Class of Modifiers: Product Modifiers

text: A modifier is a k-ary operator acting on DFAs and producing a DFA. Modifiers are involved in the theory of state complexity. We define and study a class of simple modifiers, called product modifiers, and we link closely the regular operations they encode to boolean operations.


title: Space Complexity of Stack Automata Models

text: This paper examines several measures of space complexity on variants of stack automata: non-erasing stack automata and checking stack automata. These measures capture the minimum stack size required to accept any word in a language (weak measure), the maximum stack size used in any accepting computation on any accepted word (accept measure), and the maximum stack size used in any computation (strong measure). We give a detailed characterization of the accept and strong space complexity measures for checking stack automata. Exactly one of three cases can occur: the complexity is either bounded by a constant, behaves (up to small technicalities explained in the paper) like a linear function, or it grows arbitrarily larger than the length of the input word. However, this result does not hold for non-erasing stack automata; we provide an example when the space complexity grows with the square root of the input length. Furthermore, an investigation is done regarding the best complexity of any machine accepting a given language, and on decidability of space complexity properties.


title: Equational Theories of Scattered and Countable Series-Parallel Posets

text: In this paper we consider two classes of posets labeled over an alphabet A. The class [Formula: see text] is built from the letters and closed under the operations of series finite, [Formula: see text] and [Formula: see text] products, and finite parallel product. In the class [Formula: see text], [Formula: see text] and [Formula: see text] products are replaced by [Formula: see text] and [Formula: see text] powers. We prove that [Formula: see text] and [Formula: see text] are freely generated in their respective natural varieties of algebras [Formula: see text] and [Formula: see text], and that the equational theory of [Formula: see text] is decidable.


title: Context-Freeness of Word-MIX Languages

text: In this paper we provide a decidable characterisation of the context-freeness of a Word-MIX language [Formula: see text], where [Formula: see text] is the set of all words over [Formula: see text] that contain the same number of subword occurrences of parameter words [Formula: see text].


title: On Normalish Subgroups of the R. Thompson Groups

text: Results in [Formula: see text] algebras, of Matte Bon and Le Boudec, and of Haagerup and Olesen, apply to the R. Thompson groups [Formula: see text]. These results together show that F is non-amenable if and only if T has a simple reduced [Formula: see text]-algebra. In further investigations into the structure of [Formula: see text]-algebras, Breuillard, Kalantar, Kennedy, and Ozawa introduce the notion of a normalish subgroup of a group G. They show that if a group G admits no non-trivial finite normal subgroups and no normalish amenable subgroups then it has a simple reduced [Formula: see text]-algebra. Our chief result concerns the R. Thompson groups [Formula: see text]; we show that there is an elementary amenable group [Formula: see text] (where here, [Formula: see text]) with E normalish in V. The proof given uses a natural partial action of the group V on a regular language determined by a synchronizing automaton in order to verify a certain stability condition: once again highlighting the existence of interesting intersections of the theory of V with various forms of formal language theory.


title: On the Balancedness of Tree-to-Word Transducers

text: A language over an alphabet [Formula: see text] of opening ([Formula: see text]) and closing ([Formula: see text]) brackets, is balanced if it is a subset of the Dyck language [Formula: see text] over [Formula: see text], and it is well-formed if all words are prefixes of words in [Formula: see text]. We show that well-formedness of a context-free language is decidable in polynomial time, and that the longest common reduced suffix can be computed in polynomial time. With this at a hand we decide for the class 2-TW of non-linear tree transducers with output alphabet [Formula: see text] whether or not the output language is balanced.


title: Complexity of Searching for 2 by 2 Submatrices in Boolean Matrices

text: We study the problem of finding a given [Formula: see text] matrix as a submatrix of a given Boolean matrix. Three variants are considered: search for a matching submatrix of any area, of minimum area, or of maximum area. The problem relates to 2D pattern matching, and to fields such as data mining, where the search for submatrices plays an important role. Besides these connections, the problem itself is very natural and its investigation helps to demonstrate differences between search tasks in one-dimensional and multidimensional topologies. Our results reveal that the problem variants are of different complexities. First, we show that given an [Formula: see text] Boolean matrix, the any variant can be solved in [Formula: see text] time for any given [Formula: see text] matrix, but requires various strategies for different [Formula: see text] matrices. This contrasts with the complexity of the task over matrices with entries from the set [Formula: see text], where the problem is Triangle Finding-hard and hence no algorithm with similar running time is known for it. Then, we show that the minimization variant in the case of Boolean matrices can also be solved in [Formula: see text] time. Finally, in contrast, we prove Triangle Finding-hardness for the maximization variant and show that there is a rectangular matrix multiplication-based algorithm solving it in [Formula: see text] time.


"Ich konnte einfach nicht aufhören"


Sind die Patientendaten sicher?


Dreißigzehn für wen?


"Wir sind auf uns selbst gestellt"


Global Ophthalmology Insights for a Global Pandemic


Signatures de la pandémie COVID-19 et tensions éthiques de notre modernité


title: The “F” Word

text: A beautiful word. Probably one of the simplest concepts a mind can hold, but equally controversial and conflictual in its application. An action often assumed to be altruistic but potentially more enriching than any conceivable indulgence. At times so difficult to enact and sometimes even harder to receive. Perhaps most arduous to extend to ourselves.


title: Adjuvant Effects of Platycodin D on Immune Responses to Infectious Bronchitis Vaccine in Chickens

text: Adjuvants are common vaccine components. Novel adjuvants may improve the protective immunity conferred by vaccines against poultry diseases. Here, a less-hemolytic saponin, platycodin D (PD), isolated from the root of Platycodon grandiflorum was investigated as a potential alternative adjuvant. PD was tested as an adjuvant in the infectious bronchitis (IB) vaccine, because the existing IB vaccine has often failed to induce effective immune responses. The adjuvant activity of PD in conjunction with IB vaccine was evaluated in this study. Compared to control treatment, PD treatment significantly increased the proliferation of chicken peripheral blood mononuclear cells, concentration of interferon-γ in culture supernatants, and anti-IB antibody titer. In chickens pre-challenged with the Mass 41 infectious bronchitis virus (IBV), PD administration resulted in fewer and less severe clinical signs, lower mortality rate, and higher protection compared to control treatment. Histopathological examination showed that the lungs and kidneys of PD-treated chickens displayed fewer pathological lesions than those of control chickens. Our results also demonstrated that this new vaccine adjuvant improved chicken humoral and cellular immune responses without any side effects. Hence, our findings suggest that PD might serve as an effective adjuvant in IBV vaccines.


title: Use of Starch Granules Enriched with Carvacrol for the Lesser Mealworm, Alphitobius diaperinus Control in Chicken House: Effects on Insects and Poultry

text: The aim of this study was to investigate the effect of starch granules enriched with carvacrol and mixed with straw pellets (as poultry litter) on the mortality of larvae and adults of the lesser mealworm, Alphitobius diaperinus Panzer, a cosmopolitan pest inhabiting chicken houses in vast numbers worldwide. Additionally, the effect of starch granules on the growth parameters and survival of broiler chickens exposed to treated litter was examined. In this study, granules containing 3, 5, and 10% carvacrol was used. In a simulated chicken house bioassay, this material was mixed with pellets in three different proportions: 30/70%, 40/60%, and 50/50% (granules/pellets, respectively). On this medium, young larvae (approximately 10 days old), older larvae (last stage before pupa), and unsexed 7–10 days old adults of the lesser mealworm, with access to food, were colonized. Experiments were performed at 29°C in the dark. The study shows that poultry litter with the addition of starch granules enriched with 10% of carvacrol in the proportion of 40:60% (granules:pellets) appears to be the optimal medium applicable to broiler houses for A. diaperinus control. In this environment, all larvae and adults died within 3–4 days and the overall development of the experimental chickens was similar to that of the control. However, the feed conversion rate was slightly higher in the treated group (1.72) than in the control group (1.56). The average final body weight in the treated group was 100 g lower than that in the control group (the differences were not statistically significant).


Journal of Real-Time Image Processing: third issue of volume 17


title: Corporate Law Versus Social Autonomy: Law as Social Hazard

text: This article argues that corporate law has become the legal platform upon which is erected a social process impeding society’s capacity to lucidly reflect on its primary ends; in this sense, corporate law is in conflict with social autonomy. This process is described here as a social feedback loop, in the structural centre of which lies the corporation which imposes its own purpose as an irrational social end, i.e. irrespective of its potentially catastrophic social consequences. The article argues that resolving the conflict between corporate law and social autonomy is impossible, because it presupposes a change of social paradigm towards one where corporate law as business organisation law has no obvious fit. This questions the social legitimacy of corporate law, signifies its non-permanence and thus opens up the field for seeking radical alternatives in the future.


title: Construction and Characterization of a Novel Recombinant Attenuated and Replication-Deficient Candidate Human Adenovirus Type 3 Vaccine: “Adenovirus Vaccine Within an Adenovirus Vector”

text: Human adenoviruses (HAdVs) are highly contagious and result in large number of acute respiratory disease (ARD) cases with severe morbidity and mortality. Human adenovirus type 3 (HAdV-3) is the most common type that causes ARD outbreaks in Asia, Europe, and the Americas. However, there is currently no vaccine approved for its general use. The hexon protein contains the main neutralizing epitopes, provoking strong and lasting immunogenicity. In this study, a novel recombinant and attenuated adenovirus vaccine candidate against HAdV-3 was constructed based on a commercially-available replication-defective HAdV-5 gene therapy and vaccine vector. The entire HAdV-3 hexon gene was integrated into the E1 region of the vector by homologous recombination using a bacterial system. The resultant recombinants expressing the HAdV-3 hexon protein were rescued in AD293 cells, identified and characterized by RT-PCR, Western blots, indirect immunofluorescence, and electron microscopy. This potential vaccine candidate had a similar replicative efficacy as the wild-type HAdV-3 strain. However, and importantly, the vaccine strain had been rendered replication-defective and was incapable of replication in A549 cells after more than twenty-generation passages in AD293 cells. This represents a significant safety feature. The mice immunized both intranasally and intramuscularly by this vaccine candidate raised significant neutralizing antibodies against HAdV-3. Therefore, this recombinant, attenuated, and safe adenovirus vaccine is a promising HAdV-3 vaccine candidate. The strategy of using a clinically approved and replication-defective HAdV-5 vector provides a novel approach to develop universal adenovirus vaccine candidates against all the other types of adenoviruses causing ARDs and perhaps other adenovirus-associated diseases.


Editorial: Pathogen Genomics: Empowering Infectious Disease Surveillance and Outbreak Investigations


title: Dimensions and Contradictions of the European Integration: Deepening Versus Widening

text: The second chapter tackles the question of how the European Union as an imagined community developed through the process of enlargement and integration of European states and citizens. The new model of a transnational citizenship in terms of belonging refers not only to the citizens of the member countries and resident migrants. It becomes a desirable goal for many citizens of the aspirant countries. This reflection helps understand how the prospect of joining the EU affects the democratization of the post-socialist European states, with a focus on its normative and procedural dimensions in the accession process of the ‘Western Balkan’ countries. The overall aim of the analysis is to understand the making of today’s Europe and its growing complexity, which constantly requires new arguments to legitimate the EU’s founding principles.


Mehr Beachtung der PTBS bei Kindern und Jugendlichen


title: A concept analysis of children with complex health conditions: implications for research and practice

text: BACKGROUND: This concept analysis aimed to clarify the meaning of “children with complex health conditions” and endorse a definition to inform future research, policy, and practice. METHODS: Using Walker and Avant’s (2011)‘s approach, we refined the search strategy with input from our team, including family representatives. We reviewed the published and grey literature. We also interviewed 84 health, social, and educational stakeholders involved in the care of children with complex health conditions about their use/understanding of the concept. RESULTS: We provided model, borderline, related, and contrary cases for clarification purposes. We identified defining attributes that nuance the concept: (1) conditions and needs’ breadth; (2) uniqueness of each child/condition; (3) varying extent of severity over time; 4) developmental age; and (5) uniqueness of each family/context. Antecedents were chronic physical, mental, developmental, and/or behavioural condition(s). There were individual, family, and system consequences, including fragmented services. CONCLUSIONS: Building on previous definitions, we proposed an iteration that acknowledges the conditions’ changing trajectories as involving one or more chronic condition(s), regardless of type(s), whose trajectories can change over time, requiring services across sectors/settings, oftentimes resulting in a lower quality of life. A strength of this paper is the integration of the stakeholders’/family’s voices into the development of the definition.


Psychiatrische Aspekte einer Pandemie


Chemotherapie: Bewahrt Kälte vor Neuropathie?


Ventilator-associated pneumonia in the NICU: time to boost diagnostics?


Prone Positioning following Breast Reconstruction


L’utilisation de Smartphones pour le suivi du déconfinement du Covid-19 en France


The use of Smartphones to monitor the deconfinement of Covid-19 in France


Should WALANT surgery be included in the training curriculum?


Ageism and intergenerational tensions in the COVID-19 period


Reprise du travail dans le bâtiment et les travaux publics


title: Revisiting Social Work with Older People in Chinese Contexts from a Community Development Lens: When East Meets West

text: Community development is an empowering and comprehensive method for social workers to address individual and societal challenges facing Chinese older people. This chapter explores the different meanings of community development in Chinese contexts, including communities in Mainland China and Chinese immigrant communities. When actualizing community development, social workers require theories to guide their actions, and this chapter proposes three interrelated theoretical bases: ecological system theory, empowerment theory, and anti-oppressive theory. Based on these theoretical bases, three practice directions are suggested to guide community development at different levels: “aging in place,” “age-friendly community,” and “gray power.” In particular, social workers need to adapt community development approaches to Chinese cultural contexts. Case examples are discussed to illustrate how to implement community development projects with older people in Chinese contexts and the roles of social workers in such projects.


title: Basic Income Advocacy in Canada: Multiple Streams, Experiments and the Road Ahead

text: Basic income has a long history in Canada, going back to the Great Depression. Its recognition has risen and fallen cyclically, several experiments have been mounted, and some programs, such as the Canada Child Benefit and the Old Age Security demogrant, have been identified as partial basic income schemes. However, a universal basic income for all members of the Canadian political community has never been visibly close to implementation. Against this background, this chapter examines basic income political advocacy from three vantage points. First, the multiple streams framework is used to assess linkages of basic income in the problem stream, its position in the policy stream and forces at play in the political stream. Next, the fate of experiments is described, along with approaches for increasing the likelihood that experiments will result in full-scale policy implementation if outcomes are sufficiently promising. Third, some advocacy strategies for the future are recommended.


title: The USA’s Modern Civil Rights Movement and Basic Income Guarantee

text: This chapter explores Dr. Martin Luther King Jr.’s (MLK) contribution to Basic Income Guarantee (BIG) and its association with the USA’s Modern Civil Rights Movement (MCRM). The exploration begins with a synopsis of the MCRM: its antecedents, a biographical sketch of MLK and a precis of his leadership. A discussion of MLK’s support of BIG and a brief survey of his long-term influence follow, ending with the conclusion. The goal is to identify and analyze the international thought-leader, Nobel Peace Laureate and civil rights strategist’s approach (justifications and strategies) to realizing BIG for practical and theoretical lessons that could inform future and current BIG activism.


title: Advocacy for a Universal Basic Income for the United States: My Story

text: At this moment in U.S. society, Universal Basic Income (UBI), an agreed upon amount of income distributed to the members of a society as a matter of right, is once again being given serious attention. The last time Universal Basic Income was part of a robust public discussion was in the 1960s and 1970s, when American politicians, businesspeople, and human rights activists all were talking about adequate income as a solution to poverty, automation, militarism, and racism. A plethora of writing and research exists on UBI and the effects it would have on people in the twenty-first century. While social workers are fundamentally concerned with the life cycle and systems that sustain human well-being, social workers and social work institutions remain largely absent from the fervent UBI discussion and activism that is taking place now in the United States. A social worker myself, I hope to explain here the professional and personal experiences that have driven me to commit myself to Universal Basic Income activism and strategy, and encourage the social work community and other committed people from all walks of life and all places to be part of the movement for UBI.


It’s not the mortality rate, stupid!


title: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection: let the virus be its own demise

text: There has been a collaborative global effort to construct novel therapeutic and prophylactic approaches to SARS-CoV-2 management. Although vaccine development is crucial, acute management of newly infected patients, especially those with severe acute respiratory distress syndrome, is a priority. Herein we describe the rationale and potential of repurposing a dual plasmid, Vigil (pbi-shRNA(furin)-GM-CSF), now in Phase III cancer trials, for the treatment of and, in certain circumstances, enhancement of the immune response to SARS-CoV-2.


title: Opportunity Costs Pacifism

text: If the resources used to wage wars could be spent elsewhere and save more lives, does this mean that wars are unjustified? This article considers this question, which has been largely overlooked by Just War Theorists and pacifists. It focuses on whether the opportunity costs of war lead to a form of pacifism, which it calls ‘Opportunity Costs Pacifism’. The article argues that Opportunity Costs Pacifism is, at the more ideal level, compelling. It suggests that the only plausible response to Opportunity Costs Pacifism applies in highly nonideal circumstances. This has major implications for Just War Theory and pacifism since it is only at the highly nonideal level that war can be justified.


Editor’s Introduction to v40(1)


The Effect of a Virus on Adult Development


Parker Hannifin Corp, USA


FLSmidth & Co, Denmark


Company


Orders & Contracts


Alfa Laval AB, Sweden


Atlas Copco AB, Sweden


Pentair Ltd, UK/Ireland


title: Hamworthy Pumps sees revenues increase 60%

text: Hamworthy Pumps has grown its turnover by 60% and created 26 new jobs since it was acquired by the Scandinavian investment firm Solix Group from Wärtsilä Group in 2018.


The Gorman-Rupp Co, USA


title: Desmi hit by cyber-attack

text: Danish pump company Desmi A/S suffered a cyber-attack in the week before Easter, with the attackers requesting a ransom for data recovery.


Desmi A/S, Denmark


title: Approaches to Identify Fake News: A Systematic Literature Review

text: With the widespread dissemination of information via digital media platforms, it is of utmost importance for individuals and societies to be able to judge the credibility of it. Fake news is not a recent concept, but it is a commonly occurring phenomenon in current times. The consequence of fake news can range from being merely annoying to influencing and misleading societies or even nations. A variety of approaches exist to identify fake news. By conducting a systematic literature review, we identify the main approaches currently available to identify fake news and how these approaches can be applied in different situations. Some approaches are illustrated with a relevant example as well as the challenges and the appropriate context in which the specific approach can be used.


Fostering Diaologue for a Common Future: Asia-Europe Policy Forum (AEPF)


Informatik in Zeiten von Corona


title: Preface: Patterns and processes of meiofauna in freshwater ecosystems

text: Never heard of harpacticoids, ostracods, gastrotrichs or microturbellarians? This is no surprise, they are so tiny! Yet these taxa and many others more famous (nematodes, rotifers, or tardigrades) show complex behaviours and extraordinary physiologies that allow them to colonize inland waters worldwide. This exuberant fauna is better known as the meiofauna (or meiobenthos). Meiofaunal organisms have been fascinating study objects for zoologists since the seventeenth century and recent research has demonstrated their intermediate role in benthic food webs. This special issue highlights how meiofauna can help freshwater ecologists to describe and predict species distribution patterns, to assess production of biomass and trait functions relationships, as well as to examine the trophic links between microscopic and macroscopic worlds and to better understand species’ resilience to environmental extremes. Overall, meiofaunal organisms are bridging scales, and as such they deserve better integration to develop more comprehensive concepts and theories in ecology.


Acyclovir for ventilator-associated pneumonia refractory to antibiotics and with high viral herpes simplex load: we are not sure


title: Perfectionism and Perceived Control in Posttraumatic Stress Disorder Symptoms

text: In this study, we sought to examine associations between dimensions of trait perfectionism and posttraumatic stress disorder (PTSD) symptoms among a community sample of adults who experienced at least one traumatic event and determine whether the associations between trait perfectionism dimensions and PTSD symptomatology varied as a function of perceived control. A sample of 161 (57% women; M = 33.24 years, SD = 10.84 years) community adults who experienced at least one traumatic event in their lives completed self-report measures of trait perfectionism, perceived control, personality, and PTSD symptomatology. Results from multiple regression analyses indicated that socially prescribed perfectionism was associated with higher levels of PTSD symptomatology. However, this finding was qualified by a significant interaction with perceived control such that higher levels of socially prescribed perfectionism were associated with greater PTSD symptomatology only under conditions of low perceived control. Findings underscore the importance of individual differences in socially prescribed perfectionism and perceived control for PTSD symptomatology.