Resilience, conflict and areas of limited statehood in Iraq, Lebanon and Syria

In a context of areas of limited statehood and contested order, Iraq, Lebanon and Syria have been affected by similar diffuse global and more specific regional and local risks over the past two decades. Yet they differ in outcomes. Lebanon has not descended into civil war despite fears that the one raging in Syria might spill over to its territory and Iraq has coped better over the past decade than Syria has - despite having been subject to various forms of conflict since 1980. We analyse this variance by asking to what extent resilience might buffer against violent conflict and governance breakdown. Through a comparative discussion of sources of resilience - social trust, legitimacy and institutional design - we find that limited input and threatened output legitimacy are harmful to resilience, while collective memory and reconciliation, as well as flexibility of institutions are crucial factors of resilience. Nonetheless, our findings caution that resilience should not only mean the capability to adapt to crises but also needs to set the stage for comprehensive and inclusive transformations that are locally rooted

The Case of EU Support for Resilience in the Neighbourhood

In a world of increasingly complex challenges, greater engagement between scholars and practitioners presents both sides with a significant opportunity for acquiring new knowledge. Traditional patterns of theory-practice exchange have mostly revolved around processes of knowledge transfer from scholars to officials. Academics do indeed have much to offer to policymakers; they bring a historical perspective and have extensive knowledge of the underlying causes of political and social trends, which they can also trace to policies carried out—or not carried out—by diplomats. They can thus provide policymakers with broader narratives that policymakers can use to give greater context to their action. But academics can also learn much more from policymakers. The latter do not elaborate on policies from the comfort zone of independent research. They are part of large bureaucratic processes in which multiple factors—political expediency, intra- and inter-agency coordination, number, education, and turnover rate of personnel, organizational structures, and financial resources—contribute to shaping policies. Furthermore, policymakers work within much shorter time horizons. This article takes the case of European policies in support of resilience in the EU’s neighbourhood to explore the potential of a more flexible model of theory-practice engagement based on knowledge exchange rather than transfer

Bringing Social Justice and Human Rights Back In

This report contrasts how European institutional and civil society stakeholders “talk and practice” the Mediterranean into being. Based on extensive stakeholder consultations, it tends to confirm the finding of MEDRESET Work Package 1, namely that EU institutions construct the Mediterranean through three discursive practices: the Mediterranean as a space crucial for EU interests, as a dangerous space and as a diverse geopolitical space. In stark difference to this institutional imaginary, European civil society and grassroots actors are constructing the Mediterranean space through three different discursive practices, namely the Mediterranean as a space in which universal values are being violated; as a space that is economically, but not geopolitically or ideationally, dominated by the EU; and as one where civic space is shrinking and xenophobia, authoritarianism and “wall politics” are prevailing. To rebuild an equal Mediterranean space and a flexible, inclusive and responsive EU role in it, European stakeholders suggest two policy alternatives: a policy of social justice and human rights, and a policy of reconciliation

Omentectomy for oncological surgical staging by transvaginal natural orifice transluminal endoscopic surgery (vNOTES): a preliminary study

ObjectiveThis study aimed to determine the feasibility of performing omentectomy by transvaginal natural orifice transluminal endoscopic surgery (vNOTES) for surgical staging of ovarian and high-risk endometrial malignancies.MethodsThis descriptive study was realized in a non-university hospital in Switzerland. Eighteen patients with suspicious adnexal masses or high-risk endometrial cancer underwent surgical staging comprising infracolic omentectomy by vNOTES between May 2020 and April 2023.ResultsPatients underwent oncological surgical staging for suspicious adnexal masses in 14 cases (77.8%) and high-risk endometrial cancer in 4 cases (22.2%). vNOTES omentectomies were performed in all patients without complications. Associated procedures included salpingo-oophorectomy (94.4%), hysterectomy (55.6%), peritoneal biopsies (33.3%), pelvic sentinel lymph node biopsies (22.2%), and appendectomy (5.6%). The median time to perform omentectomies was 9 (4–13) min. All oncological staging were completed by vNOTES. No significant intraoperative complications occurred. We observed 1 case (5.6%) of postoperative fever probably associated with vaginal cuff infection (Clavien-Dindo grade II).ConclusionsThis study demonstrated the feasibility of performing vNOTES oncological staging requiring complex extrapelvic procedures such as infracolic omentectomy, supporting its potential role for managing gynecological malignancies such as ovarian and high-risk endometrial cancers. However, before expanding this approach outside study settings, strong evidence of its feasibility, practical benefits, and long-term oncological outcomes are needed

The Case for a Green and Inclusive Review

The European Union (EU) has come out with a new agenda for the southern neighbourhood, reflecting a changing environment in which the Covid-19 pandemic and the need for a shared economic and social recovery are put to the forefront. Does this new agenda respond to the demands and practices of the Arab uprisings or does it revert to the stability paradigm? We argue that the EU could regain relevance in a multipolar region by putting itself more firmly behind citizens and their demands in the region. Rather than seeing citizens as “norm-takers” of the EU, it needs to begin to see them as “norm-makers”, including for the EU. Covid-19 has so far seemed to delay the EU’s entry into a new era, but it could yet act as a catalyst for the bloc to rethink its policies in the longer term. In this respect, the Green Deal may offer most potential for the EU to move forward towards a more sustainable and equitable approach that puts participatory democracy, the whole range of human rights and social–ecological justice upfront

Yellow laser performance of Dy3+^{3+} in co-doped Dy,Tb:LiLuF4_4

We present laser results obtained from a Dy$^{3+}$-Tb$^{3+}$ co-doped LiLuF$_{4}$ crystal, pumped by a blue emitting InGaN laser diode, aiming for the generation of a compact 578 nm source. We exploit the yellow Dy$^{3+}$ transition $^{4}$F$_{9/2}$ $\Longrightarrow$ $^{6}$H$_{13/2}$ to generate yellow laser emission. The lifetime of the lower laser level is quenched via energy transfer to co-doped Tb$^{3+}$ ions in the fluoride crystal. We report the growth technique, spectroscopic study and room temperature continuous wave (cw) laser results in a hemispherical cavity at 574 nm and with a highly reflective output coupler at 578 nm. A yellow laser at 578 nm is very relevant for metrological applications, in particular for pumping of the forbidden $^{1}$S$_{0} \Longrightarrow ^{3}$P$_{0}$ Ytterbium clock transition, which is recommended as a secondary representation of the second in the international system (SI) of units. This paper was published in Optics Letters and is made available as an electronic reprint with the permission of OSA. The paper can be found at the following URL on the OSA website: http://dx.doi.org/10.1364/OL.39.006628. Systematic or multiple reproduction or distribution to multiple locations via electronic or other means is prohibited and is subject to penalties under law.Comment: 8 pages, 5 figure

Towards a More Reflexive EU in the Mediterranean. Final Policy Recommendations of MEDRESET

In MEDRESET’s final policy recommendations, aimed at the new European Parliament, Commission and High Representative, we propose that the EU should become a more reflexive actor in the Mediterranean. Three related steps are key to take into this direction: (1) Substance: Begin to have periodic screening reports of EU policies and the possible harmful effects they have, and set up a study commission to reflect on a new development model for the whole Mediterranean, Europe included. (2) Actors: Work with local non-co-opted civil society and include it in all stages of policy-making towards third countries. (3) Instruments: Come forward with a reconciliation, “do no harm” and dialogue policy

The leader region of Laminin B1 mRNA confers cap-independent translation

Translation initiation of eukaryotic mRNAs generally occurs by cap-dependent ribosome scanning. However, certain mRNAs contain internal ribosome entry sites (IRES) allowing cap-independent translation. Several of these IRES-competent transcripts and their corresponding proteins are involved in tumourigenesis. This study focused on IRES-driven translation control during the epithelial to mesenchymal transition (EMT) of hepatocytes that reflects crucial aspects of carcinoma progression. Expression profiling of EMT revealed Laminin B1 (LamB1) to be translationally upregulated. The 5′-untranslated region (UTR) of LamB1 was potent to direct IRES-dependent mRNA utilization of a bicistronic reporter construct. Stringent assays for cryptic promoter and splice sites showed no aberrantly expressed transcripts, suggesting that the reporter activity provided by the leader region of LamB1 mRNA exclusively depends on IRES. In accordance, LamB1 expression increased upon negative interference with cap-dependent translation by expression of human rhinovirus 2A protease or heat shock of cells. Finally, the enhanced expression of LamB1 during EMT correlated with an elevated IRES activity. Together, these data provide first evidence that the 5′-UTR of LamB1 contains a bona fide IRES that directs translational upregulation of LamB1 during stress conditions and neoplastic progression of hepatocytes

Comparative evaluation of three clinical decision support systems: prospective screening for medication errors in 100 medical inpatients

Purpose: Clinical decision support systems (CDSS) are promoted as powerful screening tools to improve pharmacotherapy. The aim of our study was to evaluate the potential contribution of CDSS to patient management in clinical practice. Methods: We prospectively analyzed the pharmacotherapy of 100 medical inpatients through the parallel use of three CDSS, namely, Pharmavista, DrugReax, and TheraOpt. After expert discussion that also considered all patient-specific clinical information, we selected apparently relevant alerts, issued suitable recommendations to physicians, and recorded subsequent prescription changes. Results: For 100 patients with a median of eight concomitant drugs, Pharmavista, DrugReax, and TheraOpt generated a total of 53, 362, and 328 interaction alerts, respectively. Among those we identified and forwarded 33 clinically relevant alerts to the attending physician, resulting in 19 prescription changes. Four adverse drug events were associated with interactions. The proportion of clinically relevant alerts among all alerts (positive predictive value) was 5.7, 8.0, and 7.6%, and the sensitivity to detect all 33 relevant alerts was 9.1, 87.9, and 75.8% for Pharmavista, DrugReax and TheraOpt, respectively. TheraOpt recommended 31 dose adjustments, of which we considered 11 to be relevant; three of these were followed by dose reductions. Conclusions: CDSS are valuable screening tools for medication errors, but only a small fraction of their alerts appear relevant in individual patients. In order to avoid overalerting CDSS should use patient-specific information and management-oriented classifications. Comprehensive information should be displayed on-demand, whereas a limited number of computer-triggered alerts that have management implications in the majority of affected patients should be based on locally customized and supported algorithm