Internet und Armutsbekämpfung

Diese Arbeit beschäftigt sich mit den Möglichkeiten, die das Internet für soziale Entwicklung und Armutsbekämpfung bietet. Dazu werden bestehende Online-Hilfsplattformen, die Kredite, Spenden und andere Leistungen vermitteln, vorgestellt und miteinander verglichen. Das besondere Interesse gilt jenen Plattformen, die offen zugänglich sind für die Eigenaktivitäten engagierter Individuen und somit eine wertvolle Grundlage für Hilfe zur Selbsthilfe bieten. Im theoretischen Teil wird erklärt, wie aufgrund sozialer und technischer Entwicklungen neue potenzielle Ansätze in der Hilfs- und Entwicklungszusammenarbeit möglich geworden sind. Zuerst wird das Internet beschrieben und dessen neue offenere Form des Web 2.0 erklärt. Verschiedene Aspekte der Hilfsplattformen, wie das Corporate Social Responsibility-Konzept, Mikrokredite, der Digital Divide und Lösungsansätze, sowie die Umweltbelastungen durch Kommunikationstechnologien sollen eine umfassende Betrachtung der Thematik bieten. Es werden weiters gängige Methoden und die aktuellen Forderungen der Entwicklungszusammenarbeit vorgestellt. Im praktischen Teil werden die Eigenschaften der verschiedenen Spenden- und Kreditplattformen präsentiert und die bekannteren Initiativen betterplace, GiveMeaning, GlobalGiving und Kiva genauer betrachtet. Es wird untersucht, welche Art von Hilfe sie anbieten und wie sich der Zugang für Hilfsansuchen von Privatpersonen und Organisationen gestaltet. Beleuchtet wird auch, was Menschen zu sozialem Spenden und Leihen bewegt. In der Diskussion wird aufgezeigt, welche Vor- und Nachteile diese verschiedenen neuen Instrumente haben, wo die Potenziale und Risiken liegen und wie die Zukunft mit diesen Hilfsplattformen aussehen könnte. Abschließend wird noch die Idee eines visuellen Aufklärungsprogramms im Internet präsentiert. Die Ergebnisse zeigen, dass die offen zugänglichen Hilfsplattformen das Potenzial haben für ein Vorantreiben der Entwicklungshilfe hin zu weitgehender Eigenaktivität der Benachteiligten. Sie ermöglichen ein Abkehren von großen vermittelnden Institutionen, ein Umgehen von Hierarchien und Korruption sowie eine Hilfsvermittlung auf neuen Ebenen. Dadurch leisten sie einen Beitrag zur Umsetzung der gängigen Forderungen der Entwicklungszusammenarbeit nach Partizipation, Empowerment und selbst bestimmter Entwicklung. Von den betrachteten Modellen eignet sich die offen zugängliche Spendenplattform betterplace am Besten für die Selbsthilfe Benachteiligter. Sie ermöglicht eine selbst bestimmte Entwicklung durch den neuartigen Zugang zu Spendengeldern für lokal organisierte Projekte, sowie die Vermittlung konkret benötigter Hilfsmaterialien und freiwilliger Mitarbeit. Durch die Qualifikation als internationales Fundraising-Instrument wird auch internationales Zusammenzahlen für global wirksame Projekte in Größenordnungen jenseits einzelstaatlicher Finanzierbarkeit denkbar. Die Methoden für diese Arbeit sind kritische Literaturanalyse, Untersuchung und Vergleich der verschiedenen Praxisbeispiele im Internet, sowie Selbstversuche als Spender und Hilfsansuchender bei einer offenen Spenden- und einer Kreditplattform.“The Internet and the Fight against Poverty: Online Giving Marketplaces and their Potential for Assistance and Self-Help” This paper deals with the potential of the internet for social development and the fight against poverty. Different online philanthropic platforms, which offer donations, credit or other forms of assistance, are introduced and compared. The primary focus is on platforms which are accessible for individual initiatives and offer a base for self-help. In the theoretical part of this paper, social and technical developments are explored, which enable new approaches in the area of development assistance. The paper first describes the internet and its new, more open forms of the Web 2.0. Different aspects of the platforms, like the concept of Corporate Social Responsibility, micro-credits, digital divide with approaches to solutions and environmental pollution caused by information and communication technologies shall provide a proper overview on the subject. Furthermore, common methods and the current demands of development assistance are explained. The practical part of this paper presents the features of different help- and credit-platforms and the popular initiatives betterplace, GiveMeaning, GlobalGiving and Kiva are explored in more detail. The paper investigates what kinds of assistance are offered and how they are made accessible for private persons and organizations. It also examines what makes people take part in social lending and donating. In the conclusion, the advantages and disadvantages of these different new instruments are shown; highlighting their risks and potentials and what the future might look like thanks to these help-platforms. Lastly another idea is presented: The visualization of global and local developments over time with the aid of animated maps. The findings of this paper show that the help-platforms which are open to the public, have the potential to fuel development for disadvantaged groups. These platforms provide assistance on a new level by bypassing hierarchies and corruption, enabling individuals to turn away from huge intermediary institutions. Thereby a contribution is made toward the current demands of the development corporation; participation, empowerment and self-determination. Of all the models compared, the publicly accessible donation-platform betterplace is the most suited program for people seeking self-help. It enables self-determined de-velopment by making donations accessible for local projects and by the brokerage of materials for concrete needs and voluntary assistance. Because it functions as an international fundraising-instrument for global projects, rather than at the level of a single-state, feasibility can be imagined. The methods used in this paper were the critical analysis of literature, examination and comparison of the different examples in practice, as well as self-testing a donation- and a credit-platform; as both a donor and a help-applier

Effects of dalcetrapib in patients with a recent acute coronary syndrome

In observational analyses, higher levels of high-density lipoprotein (HDL) cholesterol have been associated with a lower risk of coronary heart disease events. However, whether raising HDL cholesterol levels therapeutically reduces cardiovascular risk remains uncertain. Inhibition of cholesteryl ester transfer protein (CETP) raises HDL cholesterol levels and might therefore improve cardiovascular outcomes

Combined Lithophile-Siderophile Isotopic Constraints on Hadean Processes Preserved in Ocean Island Basalt Sources

Detection of Hadean isotopic signatures within modern ocean island basalts (OIB) has greatly influenced understanding of Earth's earliest history and long-term dynamics. However, a relationship between two isotopic tools for studying early Earth processes, the short-lived 146Sm-142Nd and 182Hf-182W systems, has not been established in this context. The differing chemical behavior of these two isotopic systems means that they are complementary tracers of a range of proposed early Earth events, including core formation, magma ocean processes, and late accretion. There is a negative trend between 142Nd/144Nd and 182W/184W ratios among Réunion OIB that is extended by Deccan continental flood basalts. This finding is contrary to expectations if both systems were affected by silicate differentiation during the lifetime of 182Hf. The observed isotopic compositions are attributed to interaction between magma ocean remnants and Earth's core, coupled with later assimilation of recycled Hadean mafic crust. The effects of this scenario on the long-lived 143Nd-176Hf isotopic systematics mirror classical models invoking mixing of recycled trace-element enriched (sedimentary) and depleted (igneous) domains in OIB mantle sources. If the core provides a detectible contribution to the tungsten element budget of the silicate Earth, this represents a critical component to planetary-scale tungsten mass balance. A basic model is explored that reconciles the W abundance and isotopic composition of the bulk silicate Earth resulting from both late accretion and core-mantle interaction. The veracity of core-mantle interaction as proposed here would have many implications for long-term thermochemical cycling.National Geographic Society (NGS 8330-07 to JMDD) Geological Society of America (GSA 10539-14 to BJP) NSF (EAR-1624587 to RJW and AMP), FWF (V659-N59 to AMP) ETH Zürich/Marie Skłodowska- Curie Actions COFUND (18-1 FEL-28 to BJP) SNF (PZ00P2_180005 to BJP

The noble gas signature of the 2021 Tajogaite eruption (La Palma, Canary Islands)

Here, we characterize the temporal evolution of volatiles during the Tajogaite eruption by analyzing the elemental (He-Ar-CO2-N2) and isotopic (He-Ar-Ne) composition of fluid inclusions (FI) in phenocrysts (olivine+pyroxene) identified in erupted lavas. Our 2021 lava samples identify substantial temporal variations in volatile composition. We show that, during the 2021 Tajogaite eruption, the He-CO2-N2 concentrations in FI increased since October 15th; this increase was accompanied by increasing 40Ar/36Ar ratios (from ~300 to >500), and paralleled a major shift in bulk lava chemistry, with increasing Mg contents (Mg#, from 47 to 52 to 55–59), CaO/Al2O3 (from 0.65 to 0.74 to 0.75–0.90), Ni and Cr, and decreasing TiO2, P2O5 and incompatible elements. The olivine core composition also became more forsteritic (from Mg# = 80–81 to Mg# = 84–86). Mineral thermobarometry and FI barometry results indicate that the eruption was sustained by magmas previously stored in at least two magma accumulation zones, at respectively ~6–12 km and 15–30 km, corroborating previous seismic and FI evidence. We therefore propose that the compositional changes seen throughout the eruption can be explained by an increased contribution - since early/mid-October - of more primitive, lessdegassed magma from the deeper (mantle) reservoir. Conversely, Rc/Ra values (3He/4He ratios corrected for atmospheric contamination) remained constant throughout the whole eruption at MORB-like values (7.38 ± 0.22 Ra, 1σ), suggesting an isotopically homogeneous magma feeding source. The Tajogaite He isotope signature is within the range of values observed for the 1677 San Antonio lavas (7.37 ± 0.17Ra, 1σ), but is more radiogenic than the 3He/4He values (>9 Rc/Ra) observed in the Caldera de Taburiente to the north. The 3He/4He ratios (6.75 ± 0.20 Ra, 1σ) measured in mantle xenoliths from the San Antonio volcano indicate a relatively radiogenic nature of the mantle beneath the Cumbre Vieja ridge. Based on these results and mixing modeling calculations, we propose that the homogeneous He isotopic signatures observed in volatiles from the Tajogaite/San Antonio lavas reflect three component mixing between a MORB-like source, a radiogenic component and small additions (6–15%) of a high 3He/4He reservoir-derived (>9Ra) fluid components. The simultaneous occurrence of high 3 He/4 He (>9Ra)- and MORB-like He signatures in northern and southern La Palma is interpreted to reflect smallscale heterogeneities in the local mantle, arising from spatially variable proportions of MORB, radiogenic, and high 3He/4He component

Global survey of the frequency of atrial fibrillation-associated stroke: embolic stroke of undetermined source global registry

Background and Purpose—Atrial fibrillation (AF) is increasingly recognized as the single most important cause of disabling ischemic stroke in the elderly. We undertook an international survey to characterize the frequency of AF-associated stroke, methods of AF detection, and patient features. Methods—Consecutive patients hospitalized for ischemic stroke in 2013 to 2014 were surveyed from 19 stroke research centers in 19 different countries. Data were analyzed by global regions and World Bank income levels. Results—Of 2144 patients with ischemic stroke, 590 (28%; 95% confidence interval, 25.6–29.5) had AF-associated stroke, with highest frequencies in North America (35%) and Europe (33%) and lowest in Latin America (17%). Most had a history of AF before stroke (15%) or newly detected AF on electrocardiography (10%); only 2% of patients with ischemic stroke had unsuspected AF detected by poststroke cardiac rhythm monitoring. The mean age and 30-day mortality rate of patients with AF-associated stroke (75 years; SD, 11.5 years; 10%; 95% confidence interval, 7.6–12.6, respectively) were substantially higher than those of patients without AF (64 years; SD, 15.58 years; 4%; 95% confidence interval, 3.3–5.4; P<0.001 for both comparisons). There was a strong positive correlation between the mean age and the frequency of AF (r=0.76; P=0.0002). Conclusions—This cross-sectional global sample of patients with recent ischemic stroke shows a substantial frequency of AF-associated stroke throughout the world in proportion to the mean age of the stroke population. Most AF is identified by history or electrocardiography; the yield of conventional short-duration cardiac rhythm monitoring is relatively low. Patients with AF-associated stroke were typically elderly (>75 years old) and more often women

Multicenter, Randomized, Active Comparator-Controlled, Double-Blind, Double-Dummy, Parallel Group, Dose-Finding Phase 2 Study Comparing the Safety of the Oral FXIa Inhibitor Asundexian with Apixaban in Patients with Atrial Fibrillation

© 2022 Elsevier Ltd. All rights reserved. his is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1016/S0140-6736(22)00456-1Background Direct-acting oral anticoagulant use for stroke prevention in atrial fibrillation is limited by bleeding concerns. Asundexian, a novel, oral small molecule activated coagulation factor XIa (FXIa) inhibitor, might reduce thrombosis with minimal effect on haemostasis. We aimed to determine the optimal dose of asundexian and to compare the incidence of bleeding with that of apixaban in patients with atrial fibrillation. Methods In this randomised, double-blind, phase 2 dose-finding study, we compared asundexian 20 mg or 50 mg once daily with apixaban 5 mg twice daily in patients aged 45 years or older with atrial fibrillation, a CHA2DS2-VASc score of at least 2 if male or at least 3 if female, and increased bleeding risk. The study was conducted at 93 sites in 14 countries, including 12 European countries, Canada, and Japan. Participants were randomly assigned (1:1:1) to a treatment group using an interactive web response system, with randomisation stratified by whether patients were receiving a direct-acting oral anticoagulant before the study start. Masking was achieved using a double-dummy design, with participants receiving both the assigned treatment and a placebo that resembled the non-assigned treatment. The primary endpoint was the composite of major or clinically relevant non-major bleeding according to International Society on Thrombosis and Haemostasis criteria, assessed in all patients who took at least one dose of study medication. This trial is registered with ClinicalTrials.gov, NCT04218266, and EudraCT, 2019-002365-35. Findings Between Jan 30, 2020, and June 21, 2021, 862 patients were enrolled. 755 patients were randomly assigned to treatment. Two patients (assigned to asundexian 20 mg) never took any study medication, resulting in 753 patients being included in the analysis (249 received asundexian 20 mg, 254 received asundexian 50 g, and 250 received apixaban). The mean age of participants was 73·7 years (SD 8·3), 309 (41%) were women, 216 (29%) had chronic kidney disease, and mean CHA2DS2-VASc score was 3·9 (1·3). Asundexian 20 mg resulted in 81% inhibition of FXIa activity at trough concentrations and 90% inhibition at peak concentrations; asundexian 50 mg resulted in 92% inhibition at trough concentrations and 94% inhibition at peak concentrations. Ratios of incidence proportions for the primary endpoint were 0·50 (90% CI 0·14–1·68) for asundexian 20 mg (three events), 0·16 (0·01–0·99) for asundexian 50 mg (one event), and 0·33 (0·09–0·97) for pooled asundexian (four events) versus apixaban (six events). The rate of any adverse event occurring was similar in the three treatment groups: 118 (47%) with asundexian 20 mg, 120 (47%) with asundexian 50 mg, and 122 (49%) with apixaban. Interpretation The FXIa inhibitor asundexian at doses of 20 mg and 50 mg once daily resulted in lower rates of bleeding compared with standard dosing of apixaban, with near-complete in-vivo FXIa inhibition, in patients with atrial fibrillation.Peer reviewe

Regional, sex, and age differences in diagnostic testing among participants in the NAVIGATE-ESUS trial

Background and aim: The diagnosis of embolic stroke of undetermined source (ESUS) is based on excluding other more likely stroke etiologies, and therefore diagnostic testing plays an especially crucial role. Our objective was to compare the diagnostic testing by region, sex, and age among the participants of NAVIGATE-ESUS trial. Methods: Participants were grouped according to five global regions (North America, Latin America, Western Europe, Eastern Europe and East Asia), age (<60, 60–74, and >75 years), and sex. Frequencies of each diagnostic test within areas of echocardiography, cardiac rhythm monitoring, and arterial imaging were described and compared across groups. A multivariable logistic regression model for each diagnostic test was fit to assess the independent influence of each of region, age, and sex and likelihood of testing. Results: We included 6985 patients in the analysis (918 from North America; 746 from Latin America; 2853 from Western Europe; 1118 from Eastern Europe; 1350 from East Asia). Average age (highest in Western Europe (69 years), lowest in Eastern Europe (65 years)), % females (highest in Latin America (44%) and lowest in East Asia (31%)), and use of each diagnostic test varied significantly across regions. Region, but not sex, was independently associated with use of each diagnostic test examined. Transesophageal echocardiography and either CT or MR angiogram were more often used in younger patients. Conclusion: Diagnostic testing differed by region, and less frequently by age, but not by sex. Our findings reflect the existing variations in global practice in diagnostic testing in ESUS patients

The origin of the Moon within a terrestrial synestia

The giant impact hypothesis remains the leading theory for lunar origin. However, current models struggle to explain the Moon's composition and isotopic similarity with Earth. Here we present a new lunar origin model. High-energy, high-angular momentum giant impacts can create a post-impact structure that exceeds the corotation limit (CoRoL), which defines the hottest thermal state and angular momentum possible for a corotating body. In a typical super-CoRoL body, traditional definitions of mantle, atmosphere and disk are not appropriate, and the body forms a new type of planetary structure, named a synestia. Using simulations of cooling synestias combined with dynamic, thermodynamic and geochemical calculations, we show that satellite formation from a synestia can produce the main features of our Moon. We find that cooling drives mixing of the structure, and condensation generates moonlets that orbit within the synestia, surrounded by tens of bars of bulk silicate Earth (BSE) vapor. The moonlets and growing moon are heated by the vapor until the first major element (Si) begins to vaporize and buffer the temperature. Moonlets equilibrate with BSE vapor at the temperature of silicate vaporization and the pressure of the structure, establishing the lunar isotopic composition and pattern of moderately volatile elements. Eventually, the cooling synestia recedes within the lunar orbit, terminating the main stage of lunar accretion. Our model shifts the paradigm for lunar origin from specifying a certain impact scenario to achieving a Moon-forming synestia. Giant impacts that produce potential Moon-forming synestias were common at the end of terrestrial planet formation.Comment: Accepted for publication in Journal of Geophysical Research: Planets. Main text: 44 pages, 24 figures. Supplement: 16 pages, 5 figures, 3 table

Characteristics of Recurrent Ischemic Stroke after Embolic Stroke of Undetermined Source: Secondary Analysis of a Randomized Clinical Trial

Importance: The concept of embolic stroke of undetermined source (ESUS) unifies a subgroup of cryptogenic strokes based on neuroimaging, a defined minimum set of diagnostic tests, and exclusion of certain causes. Despite an annual stroke recurrence rate of 5%, little is known about the etiology underlying recurrent stroke after ESUS. Objective: To identify the stroke subtype of recurrent ischemic strokes after ESUS, to explore the interaction with treatment assignment in each category, and to examine the consistency of cerebral location of qualifying ESUS and recurrent ischemic stroke. Design, Setting, and Participants: The NAVIGATE-ESUS trial was a randomized clinical trial conducted from December 23, 2014, to October 5, 2017. The trial compared the efficacy and safety of rivaroxaban and aspirin in patients with recent ESUS (n = 7213). Ischemic stroke was validated in 309 of the 7213 patients by adjudicators blinded to treatment assignment and classified by local investigators into the categories ESUS or non-ESUS (ie, cardioembolic, atherosclerotic, lacunar, other determined cause, or insufficient testing). Five patients with recurrent strokes that could not be defined as ischemic or hemorrhagic in absence of neuroimaging or autopsy were excluded. Data for this secondary post hoc analysis were analyzed from March to June 2019. Interventions: Patients were randomly assigned to receive rivaroxaban, 15 mg/d, or aspirin, 100 mg/d. Main Outcomes and Measures: Association of recurrent ESUS with stroke characteristics. Results: A total of 309 patients (205 men [66%]; mean [SD] age, 68 [10] years) had ischemic stroke identified during the median follow-up of 11 (interquartile range [IQR], 12) months (annualized rate, 4.6%). Diagnostic testing was insufficient for etiological classification in 39 patients (13%). Of 270 classifiable ischemic strokes, 156 (58%) were ESUS and 114 (42%) were non-ESUS (37 [32%] cardioembolic, 26 [23%] atherosclerotic, 35 [31%] lacunar, and 16 [14%] other determined cause). Atrial fibrillation was found in 27 patients (9%) with recurrent ischemic stroke and was associated with higher morbidity (median change in modified Rankin scale score 2 [IQR, 3] vs 0 (IQR, 1]) and mortality (15% vs 1%) than other causes. Risk of recurrence did not differ significantly by subtype between treatment groups. For both the qualifying and recurrent strokes, location of infarct was more often in the left (46% and 54%, respectively) than right hemisphere (40% and 37%, respectively) or brainstem or cerebellum (14% and 9%, respectively). Conclusions and Relevance: In this secondary analysis of randomized clinical trial data, most recurrent strokes after ESUS were embolic and of undetermined source. Recurrences associated with atrial fibrillation were a minority but were more often disabling and fatal. More extensive investigation to identify the embolic source is important toward an effective antithrombotic strategy. Trial Registration: ClinicalTrials.gov Identifier: NCT02313909

Rivaroxaban or aspirin for patent foramen ovale and embolic stroke of undetermined source: a prespecified subgroup analysis from the NAVIGATE ESUS trial

Background: Patent foramen ovale (PFO) is a contributor to embolic stroke of undetermined source (ESUS). Subgroup analyses from previous studies suggest that anticoagulation could reduce recurrent stroke compared with antiplatelet therapy. We hypothesised that anticoagulant treatment with rivaroxaban, an oral factor Xa inhibitor, would reduce the risk of recurrent ischaemic stroke compared with aspirin among patients with PFO enrolled in the NAVIGATE ESUS trial. Methods: NAVIGATE ESUS was a double-blinded, randomised, phase 3 trial done at 459 centres in 31 countries that assessed the efficacy and safety of rivaroxaban versus aspirin for secondary stroke prevention in patients with ESUS. For this prespecified subgroup analysis, cohorts with and without PFO were defined on the basis of transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE). The primary efficacy outcome was time to recurrent ischaemic stroke between treatment groups. The primary safety outcome was major bleeding, according to the criteria of the International Society of Thrombosis and Haemostasis. The primary analyses were based on the intention-to-treat population. Additionally, we did a systematic review and random-effects meta-analysis of studies in which patients with cryptogenic stroke and PFO were randomly assigned to receive anticoagulant or antiplatelet therapy. Findings: Between Dec 23, 2014, and Sept 20, 2017, 7213 participants were enrolled and assigned to receive rivaroxaban (n=3609) or aspirin (n=3604). Patients were followed up for a mean of 11 months because of early trial termination. PFO was reported as present in 534 (7·4%) patients on the basis of either TTE or TOE. Patients with PFO assigned to receive aspirin had a recurrent ischaemic stroke rate of 4·8 events per 100 person-years compared with 2·6 events per 100 person-years in those treated with rivaroxaban. Among patients with known PFO, there was insufficient evidence to support a difference in risk of recurrent ischaemic stroke between rivaroxaban and aspirin (hazard ratio [HR] 0·54; 95% CI 0·22–1·36), and the risk was similar for those without known PFO (1·06; 0·84–1·33; pinteraction=0·18). The risks of major bleeding with rivaroxaban versus aspirin were similar in patients with PFO detected (HR 2·05; 95% CI 0·51–8·18) and in those without PFO detected (HR 2·82; 95% CI 1·69–4·70; pinteraction=0·68). The random-effects meta-analysis combined data from NAVIGATE ESUS with data from two previous trials (PICSS and CLOSE) and yielded a summary odds ratio of 0·48 (95% CI 0·24–0·96; p=0·04) for ischaemic stroke in favour of anticoagulation, without evidence of heterogeneity. Interpretation: Among patients with ESUS who have PFO, anticoagulation might reduce the risk of recurrent stroke by about half, although substantial imprecision remains. Dedicated trials of anticoagulation versus antiplatelet therapy or PFO closure, or both, are warranted. Funding: Bayer and Janssen