Pandemics and international security: The outlook for NATO

The Covid-19 pandemic has had a multi-faced impact on Western societies, quickly moving from a health crisis to a broader phenomenon deeply affecting the socio-economic and political landscapes. Multilateral institutions had to cope with unprecedented challenges, while the pandemic exposed existing patterns of great power competition applied to the global race for personal protective equipment, vaccines, and relevant raw materials. Nations – at least initially – seemed to abandon well- established patterns of cooperation to revert to national solutions to this very global challenge. Global economy experienced disruptions in trade and in the functioning of the Global Value Chains (GVCs), as well as significant redistributions of wealth through drastic downs and ups of Gross Domestic Product (GDP) across the world. In less than two years, the pandemic experience prompted a deep revision of standard views on critical interdependencies, diversification, resilience of GVCs and security of supplies. When it comes to international security, the pandemic mostly acted as a catalyst of existing trends, such as the geopolitical competition between the United States (US) and China – which has worsened, also due to the outbreak of the disease. As for the armed forces, in several NATO countries including France, Italy and the United Kingdom (UK), they have been called to operate in support of civilian authorities to deal with Covid-related aspects such as field hospitals, logistics, law enforcement, Covid tests or the vaccines’ distribution – and NATO itself provided support through its bodies such as the Euro-Atlantic Disaster Response Coordination Centre (EADRCC)

Neutrino search from {\gamma}-ray bursts during the prompt and X-ray afterglow phases using 10 years of IceCube public data

Neutrino emission from gamma-ray bursts (GRBs) has been sought for a long time, and stringent limits on the most accredited GRB emission models have been obtained from IceCube. Multi-wavelength GRB observations of the last decades improved our knowledge of the GRB emission parameters, such as the Lorentz factor and the luminosity, which can vary from one GRB to another by several orders of magnitude. Empirical correlations among such parameters have been identified during the prompt phase, with direct implications on GRB models. In this work, we use the PSLab open-access code, developed for IceCube data analyses, to search for individual neutrino emission from the prompt and afterglow phases of selected GRBs, and for stacking emission from the ensemble of such GRBs. For the afterglow phase, we focus in particular on GRBs with X-ray flares and plateaus. While past stacking searches assumed the same GRB fluence at Earth, we present a stacking scheme based on physically motivated GRB weights. Moreover, we conceive a new methodology for the prompt phase that uses the empirical correlations to infer the GRB luminosity and Lorentz factor, when redshift measurements are not available. We do not observe any significant neutrino excess. Hence, we set constraints on the GRB neutrino fluxes and on relevant GRB parameters, including the magnetic field in the jet. Notably, the baryon loading is found to be <10 for typical GRB prompts, thus disfavoring a baryonic-dominated origin of the GRB ejecta.Comment: Submitted for publication to A&A. Comments are welcom

Multi-Wavelength Observations of the HBL Object 1ES 1011+496 in Spring 2008

In the spring of 2008 MAGIC organised multi-wavelength (MWL) observations of the blazar 1ES 1011+496. 1ES 1011+496 is a high-frequency peaked BL Lac object discovered at VHE gamma-rays by MAGIC in spring 2007 during an optical outburst reported by the Tuorla Blazar Monitoring Programme. MAGIC re-observed the source during the 2008 MWL campaign which also included the Mets\"ahovi, KVA, Swift and AGILE telescopes. This was the first MWL campaign on this source that also included VHE coverage. MAGIC observed 1ES 1011+496 from March 4th to May 24th 2008 for a total of 27.9 hours, of which 20 h remained after quality cuts. The observations resulted in a detection of the source a ~7 sigma significance level with a mean flux and spectral index similar to those during the discovery. Here we will present the results of the MAGIC observations of the source in combination with contemporaneous observations at other wavelengths (radio, optical, X-rays, high energy gamma-rays) and discuss their implications on the modelling of the spectral energy distribution.Comment: 4 pages, 5 figures, contribution to the 32nd ICRC, Beijing 201

Cardiac rehabilitation protocols in the elderly.

Cardiac rehabilitation (CR) is a comprehensive multidisciplinary program individually tailored to the needs of patients with cardiovascular disease. Cardiovascular disease is prevalent in older adults and is the leading cause of death and major disability in adults ≥75 years of age. The mean age of patients eligible for CR is increasing, with greater complexity and specific geriatric features, such as multimorbidity, frailty, and disability. In this population, CR interventions should be aimed to prevent disability and preserve the residual functional capacity. Every patient should be assessed with a multidimensional evaluation that includes clinical, functional, emotional, cognitive and social domains. Exercise-based CR programs have shown to be effective in improving function and quality of life, by reducing disability and age-related deconditioning and contributing favorably to improved health outcomes in an aged population. Very old and frail patients seem to get an even greater potential benefit, and an early start after an acute event can prevent the post-hospital syndrome. Despite these proven benefits, CR is often underused in this population and a great effort should be done to encourage them to attend these programs. There are just a few studies about CR programs in very old and frail patients, therefore a future goal should be to fill this gap

Comparison of 10-year overall survival between patients with G1 and G2 grade Ta bladder tumors

To compare long-term overall survival (OS) in patients with G1 and G2 grade Ta bladder cancer after transurethral resection of bladder tumors (TURBTs). Secondary aim was to investigate clinical and pathologic prognostic factors for OS of Ta patients, except G3/high grade (HG). A total of 243 patients, retrospectively selected, with Ta nonmuscle invasive bladder cancer (NMIBC) underwent TURBT between January 2006 and December 2008 (median follow-up 109 months). Inclusion criteria were: Ta at first manifestation, G1 or G2 grade with no associated carcinoma in situ (CIS). Seventy-nine patients were excluded due to concomitant CIS (1), G3/HG tumors (47), and lost to follow-up (31). Ethical approval was obtained from the Ethical Committee of the Mures County Hospital. Statistical analysis was performed using STATA 11.0. Following inclusion criteria, 164 patients with primary G1 or G2 Ta tumors, were enrolled. Recurrence was observed in 26 (15.8%) and progression in 5 (3%) patients. Ten-year survival in G1 patients was 67.8% (CI 54.3-78.1) and in G2 patients 59% (CI 49-67.3) (P=.31). Univariable and multivariable logistic regression analysis underlined that advanced age at diagnosis (hazard ratio [HR] 1.10) and no Bacillus Calmette-Guerin (BCG) treatment (HR 0.24 and 0.29) were independent predictors for death at 10 years after diagnosis. Long-term analysis confirms that patients with well differentiated (G1) and moderately well differentiated (G2) Ta tumors have similar OS. A longer OS was even reported in those who underwent BCG adjuvant therapy

A novel splicing mutation in the ABCA1 gene, causing Tangier disease and familial HDL deficiency in a large family.

International audience; Tangier disease is a rare disorder of lipoprotein metabolism that presents with extremely low levels of HDL cholesterol and apoprotein A-I. It is caused by mutations in the ATP-binding cassette transporter A1 (ABCA1) gene. Clinical heterogeneity and mutational pattern of Tangier disease are poorly characterized. Moreover, also familial HDL deficiency may be caused by mutations in ABCA1 gene. ATP-binding cassette transporter A1 (ABCA1) gene mutations in a patient with Tangier disease, who presented an uncommon clinical history, and in his family were found and characterized. He was found to be compound heterozygous for two intronic mutations of ABCA1 gene, causing abnormal pre-mRNAs splicing. The novel c.1510-1G > A mutation was located in intron 12 and caused the activation of a cryptic splice site in exon 13, which determined the loss of 22 amino acids of exon 13 with the introduction of a premature stop codon. Five heterozygous carriers of this mutation were also found in proband's family, all presenting reduced HDL cholesterol and ApoAI (0.86 ± 0.16 mmol/L and 92.2 ± 10.9 mg/dL respectively), but not the typical features of Tangier disease, a phenotype compatible with the diagnosis of familial HDL deficiency. The other known mutation c.1195-27G > A was confirmed to cause aberrant retention of 25 nucleotides of intron 10 leading to the insertion of a stop codon after 20 amino acids of exon 11. Heterozygous carriers of this mutation also showed the clinical phenotype of familial HDL deficiency. Our study extends the catalog of pathogenic intronic mutations affecting ABCA1 pre-mRNA splicing. In a large family, a clear demonstration that the same mutations may cause Tangier disease (if in compound heterozygosis) or familial HDL deficiency (if in heterozygosis) is provided

A novel mutation in NDUFB11 unveils a new clinical phenotype associated with lactic acidosis and sideroblastic anemia

NDUFB11, a component of mitochondrial complex I, is a relatively small integral membrane protein, belonging to the 'supernumerary' group of subunits, but proved to be absolutely essential for the assembly of an active complex I. Mutations in in the X-linked nuclear encoded NDUFB11 gene have recently been discovered in association with two distinct phenotypes, i.e. microphthalmia with linear skin defects and histiocytoid cardiomyopathy. We report on a male with complex I deficiency, caused by a de novo mutation in NDUFB11 and displaying early onset sideroblastic anemia as the unique feature. This is the third report that describes a mutation in NDUFB11 but all are associated to a different phenotype. Our results further expand the molecular spectrum and associated clinical phenotype of NDUFB11 defects

Quality of Life and Psychological Distress among Patients with Small Renal Masses

Quality of life (QoL) and psychological distress represent an important aspect of the daily life of cancer patients. The aim of this systematic review was to critically analyze available literature regarding QoL and psychological distress in patients with small renal masses (SRMs). (2) Methods: A systematic search of EMBASE, PUBMED and American Psychological Association (APA-net) was performed on 30 April 2022. Studies were considered eligible if they included patients with SRMs, had a prospective or retrospective design, included at least 10 patients, were published in the last 20 years, and assessed the QoL or psychological distress in patients that underwent active surveillance (AS) in comparison to those that underwent ablation/surgery treatments. (3) Results: The patients that underwent AS were statistically significantly older, with smaller renal masses than those that underwent surgery/ablation. A study showed a significant reduction in total scores of Short Form-12 (SF-12) among AS patients when compared to partial nephrectomy (PN) patients at enrollment (95.0 ± 15.8 vs. 99.1 ± 13.9), 2 years (91.0 ± 16.4 vs. 100.3 ± 14.3), and at 3 years (92.9 ± 15.9 vs. 100.3 ± 14.3), p &lt; 0.05, respectively. That was mainly due to lower physical health scores. On the other hand, another study showed that AS patients with a biopsy-proven malignant tumor had a worse psychological distress sub-score (PDSS) compared to patients treated with surgery/ablation after biopsy. (4) Conclusions: It seems that there is an influence on QoL and psychological distress while on AS of SMRs. However, due to the low amount of available data, the impact of AS or active treatment on QoL or psychological distress of patients with small renal masses warrants further investigation