The EU, China and Southeast Asia: Divergent Views of Dealing with Human Security. Jean Monnet/Robert Schuman Paper Series Vol. 14 No. 8, May 2014

Introduction. This chapter takes a closer look at the European Union (EU), China, and the Association of Southeast Asian Nations (ASEAN)’s respective approaches to dealing with non-traditional security (NTS) challenges by investigating their policies toward Burma/Myanmar—a source country of numerous such challenges. It argues that, although all, as members of the ASEAN Regional Forum (ARF), see the need for multilateral solutions to fight organized crime, provide disaster relief, combat terrorism, prevent drug trafficking, etc., they differ with respect to the steps to be taken to protect human security in Asia-Pacific. China, initially hesitant to join the ARF for fear that other members might try to contain it, has come to value the principal forum for NTS challenges in the Asia-Pacific region since, like many ASEAN countries, it is a big proponent of non-interventionism, non-use of force, consensus decision-making, that is, the confidence-building mechanisms commonly referred to as the ‘ASEAN way’.2 The EU, as a strong proponent of human rights and the rule of law, repeatedly, has criticized ARF members for allowing sovereignty-related norms to get in the way of the protection of human rights, but it has refrained from assuming the role of norm exporter. As will be seen in the case of Burma/Myanmar, the EU does make its opinions heard and, when necessary, will take unilateral steps not supported by the ASEAN members of the ARF but, cognizant of the history of the region, for the most part, settles for supporting economic development and aiding in capacity-building, understanding that it would be counter-productive to exert pressure on reluctant ARF members to modify the non-interference norm. The chapter then speculates about the ‘ASEAN way’s’ longevity, arguing that, increasingly, there are internal and external dynamics that seem to indicate that the ‘ASEAN way,’ at least in its current form, may not be here to stay. The conclusion looks at what might be in store for Burma/Myanmar in the years to come

Epidemiologie von Infektionen mit multiresistenten Erregern bei akuter myeloischer Leukämie

Infection and colonisation with focus on resistant bacteria in AML patients receiving intensive chemorherapy. Background: Infections and colonization caused by resistant bacteria are a widespread problem and require complex hygienic efforts. In this thesis the colonization and infection with problematic resistant bacteria (VRE, 3/4MRGN, MRSA) and C.difficile in AML-patients were explored for a period of six years (2011-2016) using retrospective data. Methods: 119 consecutive patients, who received chemotherapy (119 induction cycles with SHAM and 66 consolidation) between 01.01.2011 and 31.12.2016 were analyzed. We retrospectively analyzed all available data from patient documentation, microbiological, radiological and labaratory findings. Follow up ended with discharge. Patients were analyzed regarding developing fever in neutropenia and fulfilling criteria of sepsis (BSI + HR >100/min; T >38°C; RR >20/min; neutropenia. BSI + two criteria = sepsis) or not. Results: Patients, who underwent induction therapy had a mean duration of neutropenia of 29 days patients receiving consolidation therapy of 16 days. All of the induction patients developed fever (vs. 97% of the consolidation patients). Microbiological screening procedures were performed in 18% (22) of the inductions no positive result. Screenings were done in 18% (12) of consolidations and showed two positive results. There is an increasing trend to do screenings over the years, with most frequent tests in 2016. The criteria of sepsis were fulfilled in 56% (67) of all 119 patients in induction, and in 45% (30) of all 66 patients in consolidation. Infection episodes with detection of VRE or 3MRGN in blood culture were seen in 5 patients with induction and in 3 patients with consolidation. All patients were treated according to resistance testing. Detection of VRE or 3/4MRGN in other media than blood culture were seen in 10 induction patients and 9 consolidation patients and interpreted as colonisation. 21% (14) out of 66 patients with consolidation had complications (infection or colonisation) with problematic bacteria, seven of these cases showed the same germ (VRE or 3MRGN) as detected in induction. During the six years we see an increase of positive results for resistant bacteria in induction, starting and reaching a plateau in 2014 (6 positive results). In consolidation the peak was 2015 (6 positive results) with a decrease in 2016 (2). Clostridium difficile infections (C. diff associated diarrhea, CDAD) were seen in 6 patients receiving induction therapy and in 4 patients during consolidation. Conclusion: complications (Infections/colonisations) with bacteria carrying resistances to commonly used antibiotics and CDAD are high in AML patients (19%, n=185). The increasing number of resistant isolates reported in national and international surveillance studies should initiate a discussion about their causes and about strategies to prevent the transmission in AML patients

Diagnostische Methodenkombination zur Differenzierung von atypischen Parkinsonvarianten und idiopathischem Parkinson-Syndrom

Die Parkinsonerkrankung (Morbus Parkinson) ist eine der häufigsten neurodegenerativen Erkrankungen, deren Inzidenz und Prävalenz mit dem Alter ansteigt. Die Erkrankung ist durch den Symptomenkomplex Rigor, Tremor und Akinese charakterisiert. Bei der klinischen Diagnose bleibt bei circa 15-20% der Patienten eine Unsicherheit, ob es sich um einen M. Parkinson oder ein atypisches Parkinson-Syndrom handelt. Das klinische Bild kann insbesondere zu Beginn der Erkrankung sehr ähnlich sein. Aufgrund der unterschiedlichen Prognose, Therapie und Lebenserwartung, die mit den verschiedenen Erkrankungen verbunden ist, ist eine frühzeitige Unterscheidung wünschenswert. Daher ist zur weiteren Differenzierung eine apparative Zusatzdiagnostik notwendig. Zahlreiche bildgebende Verfahren wurden vorgeschlagen, ohne dass sich eine Methode im klinischen Alltag mit ausreichender Sensitivität und Spezifität durchsetzen konnte. Bei Anwendung der Diffussionswichtung hat die hohe Inzidenz von vaskulären Läsionen (WML) in dieser Altersgruppe immer wieder zu Diskussionen über deren Einfluss auf die Messergebnisse geführt. Die vorliegende Arbeit hat das Ziel zu untersuchen: 1. Ob im Einzelfall eine Differenzierung zwischen M. Parkinson und atypischen Parkinsonerkrankungen mittels dem MRT und der Hirnparenchymsonographie möglich ist. 2. Ob das Vorhandensein von WML die Diagnosefindung beeinflusst Es wurden die MRTs von je 20 Patienten mit M. Parkinson (Idiopathic Parkinsonsons disease =IPD), M. Parkinson (IPD) mit vaskulären Läsionen, Multisystematrophiecerebellare Variante (MSA-C), Multisystematrophie mit Parkinsonsymptomatik (MSAP) und progressiver Blickparese (progressive supranuclear palsy = PSP) bezüglich des Auftretens von einer Atrophie des Kortex, des Kleinhirns, des Mittelhirns, des Putamens und der Pons sowie eines Signalanstiegs des Kleinhirnstiels, einer kreuzförmigen Hyperintensität im Bereich der Pons („hot cross bun sign“) und einer lateral des Putamen gelegene Hyperintensität (hyperintense rim) untersucht. Zusätzlich wurden die ADC Werte im Bereich de Putamens, Pallidums und des mittleren Kleinhirnstiels und die Ergebnisse der Hirnparenchymsonographie zur Differenzierung herangezogen. Im konventionellen MRT zeigten sich die erwarteten, typischen Befunde für Patienten mit IPD, IPD mit vaskulären Läsionen, MSA-P, MSA-C und PSP. Mit einer Sensitivität der Veränderungen von maximal 40-65% war jedoch keine ausreichende Differenzierung möglich. Die Messwerte des regionalen Diffusionskoeffizienten im Putamen erlaubten eine eindeutige Abgrenzung der idiopathischen Parkinsonerkrankung von den atypischen Parkinson-Syndromen. Zur weiteren Unterscheidung der atypischen Parkinsonvarianten ergab sich eine eindeutige Differenzierung von MSA-P zu PSP in allen Messregionen in der DWI. Für die Diagnose einer MSA-C stellte sich das Putamen als diskriminierungstärkste Region heraus, während bei der PSP der mittlere Kleinhirnstiel (MCP) die beste Unterscheidungsmöglichkeit darstellte. Die vaskulären Läsionen reduzierten die Trennschärfe bei der Unterscheidung zwischen M.Parkinson und PSP. Die Hirnparenchymsonographie ergab durch die Hyperintensität der Substantia nigra bei IPD eine vollständige Diskriminierung zu den atypischen Parkinsonvarianten. Die Unterscheidung der atypischen Parkinsonsyndrome wird durch die Messung der Weite des 3. Ventrikels unterstützt. Es fand sich eine eindeutige Diskriminierung zwischen MSA-P und PSP. Um in Zweifelsfällen eine atypische Parkinsonerkrankung von einem M. Parkinson zu unterscheiden empfiehlt sich folgerichtig die Anwendung beider Techniken um eine möglichst hohe Diagnosesicherheit zu erreichen.Idiopathic Parkinsons disease is one of the most frequent neurodegenerative diseases characterized by the clinical hallmarks rigidity, tremor and akinesia. The incidence and prevalence increases with age. In 15-20% of patients with parkinsonian symptoms the diagnosis remains uncertain. The clinical symptoms of idiopathic Parkinsons disease and those of an atypical Parkinsons disease may be very similar in early stages. However, an early differentiation between Parkinsons disease and atypical Parkinsons disease is crucial for determining the prognosis and life expectancy and choosing a treatment strategy. Therefore, additional diagnostic tools are necessary. Numerous imaging techniques have been suggested but none had sufficient sensitivity to help with the diagnosis in individual patients. Diffusions weighted imaging (DWI) seems to be very promising but the high incidence of white matter lesions (WML) in the elderly have raised the question whether the WML might influence the ADC measurements. The aim of the current study is to investigate whether a. MRI and transcranial sonography can help to differentiate between IPD and atypical Parkinsons disease b. The presence of WML influences the diagnosis of IPD. Method: The MRIs of 20 patients with IPD with and without white matter lesions, 20 patients with PSP, 20 patients with MSA-P and MSA-C were analyzed. Abnormalities on MRI including atrophy of the cortex, cerebellum, midbrain, putamen, pons, hyperinetnsity of the middle cerebellar peduncle, cruciform hyperintensity of the pons (hot cross bun sign) and hyperintense putaminal rim were recorded. In addition DWI was conducted and ADC was compared in the putamen, pallidum and cerebellar peduncle. Furthermore, all patients were examined by using transcranial ultrasonography. Results: The traditional MRI sequences showed the expected results in accordance with the literature. However, the sensitivity was too low for differentiation between IPD and atypical PD in individual patients. In contrast the regional ADC in the putamen provided a complete separation between IPD and atypical PD. There was no overlap between MSA-P and PSP based on putaminal, pallidal and cerebellar ADC. Putaminal ADC provided the best results for diagnosis of MSA-C. ADC in the middle cerebellar peduncle permitted the differentiation of PSP. The occurrence of white matter lesions reduced the discriminatory power of DWI between IPD and PSP. The transcranial ultrasound provided a complete separation between IDP and atypical Parkinsons disease. Apart from the hyperintensity of the substantia nigra the width of the third ventricle contributed to the differentiation between the various atypical PD. In conclusion the combination of transcranial ultrasonography and various MRI techniques might reduce the rate of misdiagnosis in early PD

Surface Modification Strategies for Improving the Cycling Performance of Ni-Rich Cathode Materials – Surface Modification Strategies for Improving the Cycling Performance of Ni-Rich Cathode Materials

Ni‐rich layered lithium metal oxides are the cathode active materials of choice for high‐energy‐density Li‐ion batteries. While the high content of Ni is responsible for the excellent capacity, it is also the source of interfacial instability, limiting the material\u27s lifetime due to a variety of correlated in‐ and extrinsic factors. Hence, reconciling the opposing trends of high Ni content and long‐term cycling stability by modifying the material\u27s surface is one of the challenges in the field. Here, we review various studies on surface modification of Ni‐rich (≥ 80 %) layered cathode active materials in order to categorize current research efforts. Broadly, the three strategies of coating, surface doping and washing are discussed, each with their advantages and shortcomings. In conclusion, we highlight new directions of research that could bring Ni‐rich layered lithium metal oxide cathodes from the laboratory to the real world

Antiretroviral Therapy Reduces Markers of Endothelial and Coagulation Activation in Patients Infected with Human Immunodeficiency Virus Type 1

We investigated the effect of antiretroviral therapy on vascular activation in 41 human immunodeficiency (HIV)—infected patients receiving a regimen that included either at least 1 protease inhibitor (PI; n = 21) or a nonnucleoside reverse-transcriptase inhibitor (NNRTI; n = 20). Acontrol group of 21 healthy subjectswas included for comparison. Levels of endothelialmarkers (soluble vascular cell adhesion molecule [sVCAM]-1, soluble intercellular adhesionmolecule-1, and vonWillebrand factor) were higher in HIV-infected persons before treatment than in control subjects anddecreasedsignificantlyafter 5-13 months of treatment. Levels of sVCAM-1 and vonWillebrand factor correlated significantly with initial virus load. D-dimer concentrations also decreased significantly after initiation of treatment. PI- and NNRTI-containing regimens had similar effects. Therapy did not reduce levels of the soluble platelet (sP) activation markers sP-selectin and CD40 ligand. The inhibition of markers of vascular activation may counterbalance sequelae of therapy-induced dyslipidemia and potentially prevent development of atherosclerosis in HIVinfected patient

Upregulated expression of ENaC in human CF nasal epithelium

AbstractCystic fibrosis (CF) is characterised by the absence of CFTR function resulting in a reduced Cl− secretion and an increase in Na+ absorption. This Na+ hyperabsorption is mediated by the human amiloride-sensitive epithelial sodium channel (ENaC), but the underlying mechanisms are still unknown. After demonstrating functional differences of the Na+ absorption in CF and non-CF epithelia in Ussing chamber experiments with human primary cultures, we compared ENaC sequences from CF and non-CF human nasal tissue (hnENaC), investigated the mRNA transcription levels via real-time PCR and studied the protein expression in Western blot analyses. We found no differences in the sequences of CF and non-CF hnENaC, but identified some polymorphisms. The real-time experiments revealed an enhanced mRNA amount of all three hnENaC subunits in CF tissue. By comparing the two groups on the protein level, we observed differences in the abundance of the Na+ channel. While the α- and β-hnENaC protein amount was increased in CF tissue the γ-hnENaC was decreased. We conclude that the Na+ hyperabsorption in CF is not caused by mutations in hnENaC, but by an increase in the transcription of the hnENaC subunits. This could be induced by a disturbed regulation of the channel in CF

Genome mining in Amycolatopsis balhimycina for ferredoxins capable of supporting cytochrome P450 enzymes involved in glycopeptide antibiotic biosynthesis

Ferredoxins are required to supply electrons to the cytochrome P450 enzymes involved in cross-linking reactions during the biosynthesis of the glycopeptide antibiotics balhimycin and vancomycin. However, the biosynthetic gene clusters for these antibiotics contain no ferredoxin- or ferredoxin reductase-like genes. In a search for potential ferredoxin partners for these P450s, here, we report an in silico analysis of the draft genome sequence of the balhimycin producer Amycolatopsis balhimycina, which revealed 11 putative Fe-S-containing ferredoxin genes. We show that two members (balFd-V and balFd-VII), produced as native-like holo-[3Fe-4S] ferredoxins in Escherichia coli, could supply electrons to the P450 OxyB (CYP165B) from both A. balhimycina and the vancomycin producer Amycolatopsis orientalis, and support in vitro turnover of peptidyl carrier protein-bound peptide substrates into monocyclic cross-linked products. These results show that ferredoxins encoded in the antibiotic-producing strain can act in a degenerate manner in supporting the catalytic functions of glycopeptide biosynthetic P450 enzymes from the same as well as heterologous gene cluster

Mobility choices - an instrument for precise automatized travel behavior detection & analysis

Within the Mobility Choices (MC) project we have developed an app that allows users to record their travel behavior and encourages them to try out new means of transportation that may better fit their preferences. Tracks explicitly released by the users are anonymized and can be analyzed by authorized institutions. For recorded tracks, the freely available app automatically determines the segments with their transportation mode; analyzes the track according to the criteria environment, health, costs, and time; and indicates alternative connections that better fit the criteria, which can individually be configured by the user. In the second step, the users can edit their tracks and release them for further analysis by authorized institutions. The system is complemented by a Web-based analysis program that helps authorized institutions carry out specific evaluations of traffic flows based on the released tracks of the app users. The automatic transportation mode detection of the system reaches an accuracy of 97%. This requires only minimal corrections by the user, which can easily be done directly in the app before releasing a track. All this enables significantly more accurate surveys of transport behavior than the usual time-consuming manual (non-automated) approaches, based on questionnaires