Trouble with the Neighbors: A Case Study of the Political Relationship Between the Baltic States and Euro-Atlantic Security Institutions After Russia\u27s Annexation of the Crimean Peninsula

This paper assesses the current state of the European security community in the aftermath of Russia\u27s annexation of Crimea from the perspective of the three Baltic countries. The research qualitatively analyzes government documents, official statements, and publications by, and interviews with, scholars and policymakers to determine how recent Russian behavior has affected the perspective of the Baltic states, and how they have affected NATO and the EU. This paper finds that the annexation of Crimea vindicated those in the Baltic who had expected such behavior, and determines that the Baltic states have leveraged the EU and NATO to refocus attention on their eastern flank

Adaptive Effects on Locomotion Performance Following Exposure to a Rotating Virtual Environment

During long-duration spaceflight, astronauts experience alterations in vestibular and somatosensory cues that result in adaptive disturbances in balance and coordination upon return to Earth. These changes can pose a risk to crew safety and to mission objectives if nominal or emergency vehicle egress is required immediately following long-duration spaceflight. At present, no operational countermeasure is available to mitigate the adaptive sensorimotor component underlying the locomotor disturbances that occur after spaceflight. Therefore, the goal of this study is to develop an inflight training regimen that facilitates recovery of locomotor function after long-duration spaceflight. The countermeasure we are proposing is based on the concept of adaptive generalization. During this type of training the subject gains experience producing the appropriate adaptive motor behavior under a variety of sensory conditions and response constraints. As a result of this training a subject learns to solve a class of motor problems, rather than a specific motor solution to one problem, i.e., the subject learns response generalizability or the ability to "learn to learn." under a variety of environmental constraints. We are developing an inflight countermeasure built around treadmill exercise activities. By manipulating the sensory conditions of exercise by varying visual flow patterns, body load and speed we will systematically and repeatedly promote adaptive change in locomotor behavior. It has been shown that variable practice training increases adaptability to novel visuo-motor situations. While walking over ground in a stereoscopic virtual environment that oscillated in roll, subjects have shown compensatory torso rotation in the direction of scene rotation that resulted in positional variation away from a desired linear path. Thus, postural sway and locomotor stability in 1-g can be modulated by visual flow patterns and used during inflight treadmill training to promote adaptive generalization. The purpose of this study was to determine if adaptive modification in locomotor performance could be achieved by viewing simulated self-motion in a passive-immersive virtual ' environment over a prolonged period during treadmill locomotion

The Use of Social Media and Digital Devices Among Italian Neurologists

Background: Digital devices and online social networks are changing clinical practice. In this study, we explored attitudes, awareness, opinions, and experiences of neurologists toward social media and digital devices. Methods: Each member of the Italian Society of Neurology (SIN) participated in an online survey (January to May 2018) to collect information on their attitude toward digital health. Results: Four hundred and five neurologists participated in the study. At work, 95% of responders use the personal computer, 87% the smartphone, and 43.5% the tablet. These devices are used to obtain health information (91%), maintain contact with colleagues (71%), provide clinical information (59%), and receive updates (67%). Most participants (56%) use social media to communicate with patients, although 65% are against a friendship with them on social media. Most participants interact with patients on social media outside working hours (65.2%) and think that social media have improved (38.0%) or greatly improved (25.4%) the relationship with patients. Most responders (66.7%) have no wearable devices available in clinical practice. Conclusion: Italian neurologists have different practices and views regarding the doctor–patient relationship in social media. The availability of digital devices in daily practice is limited. The use of social networks and digital devices will increasingly permeate into everyday life, bringing a new dimension to health care. The danger is that advancement will not go hand in hand with a legal and cultural adaptation, thus creating ambiguity and risks for clinicians and patients. Neurologists will need to be able to face the opportunities and challenges of this new scenario

La política antidrogas: nuevos horizontes de cambio en el control de la oferta y la demanda

96 p.De acuerdo con la Organización Mundial de la Salud (OMS, 1994) una sustancia o droga psicoactiva es aquella que, al ingerirse, afecta procesos mentales, como la cognición o la memoria. El término es asemejado generalmente con el de psicotrópico y ambas expresiones refieren al grupo de sustancias, legales e ilegales, de interés para la política en materia de drogas. En general, la literatura refiere con el término psicotrópico, a medicamentos utilizados principalmente en el tratamiento de los trastornos mentales, como los ansiolíticos, sedantes, antidepresivos, anti maníacos y neurolépticos. Bajo la categoría de sustancias psicotrópicas se encuentran los estupefacientes, acepción utilizada para referirse a sustancias cuya acción sedante, analgésica, narcótica y euforizante puede conducir al acostumbramiento y a la toxicomanía, por lo cual tienen un elevado potencial de abuso y / o dependencia psíquica/física. Entre ellos, se cuentan los estimulantes -cocaína, cafeína, nicotina-, los alucinógenos -Peyote y Psilocybes, los opiáceos -morfina, heroína-, y los sedantes/hipnóticos -alcohol- (OMS, 1994).Prólogo Introducción Capítulo 1. El panorama global: evolución reciente del fenómeno del consumo de sustancias psicoactivas Capítulo 2. La junta internacional de fiscalización de estupefacientes y la eficacia de la política antidrogas: el caso colombiano Capítulo 3. Hacia nuevos horizontes del análisis de política antidrogas Conclusiones Bibliografí

Data monitoring roadmap. The experience of the Italian Multiple Sclerosis and Related Disorders Register

Introduction Over the years, disease registers have been increasingly considered a source of reliable and valuable population studies. However, the validity and reliability of data from registers may be limited by missing data, selection bias or data quality not adequately evaluated or checked.This study reports the analysis of the consistency and completeness of the data in the Italian Multiple Sclerosis and Related Disorders Register.MethodsThe Register collects, through a standardized Web-based Application, unique patients.Data are exported bimonthly and evaluated to assess the updating and completeness, and to check the quality and consistency. Eight clinical indicators are evaluated.ResultsThe Register counts 77,628 patients registered by 126 centres. The number of centres has increased over time, as their capacity to collect patients.The percentages of updated patients (with at least one visit in the last 24 months) have increased from 33% (enrolment period 2000-2015) to 60% (enrolment period 2016-2022). In the cohort of patients registered after 2016, there were >= 75% updated patients in 30% of the small centres (33), in 9% of the medium centres (11), and in all the large centres (2).Clinical indicators show significant improvement for the active patients, expanded disability status scale every 6 months or once every 12 months, visits every 6 months, first visit within 1 year and MRI every 12 months.ConclusionsData from disease registers provide guidance for evidence-based health policies and research, so methods and strategies ensuring their quality and reliability are crucial and have several potential applications

Disease-Modifying Therapies and Coronavirus Disease 2019 Severity in Multiple Sclerosis

Objective: This study was undertaken to assess the impact of immunosuppressive and immunomodulatory therapies on the severity of coronavirus disease 2019 (COVID-19) in people with multiple sclerosis (PwMS). Methods: We retrospectively collected data of PwMS with suspected or confirmed COVID-19. All the patients had complete follow-up to death or recovery. Severe COVID-19 was defined by a 3-level variable: mild disease not requiring hospitalization versus pneumonia or hospitalization versus intensive care unit (ICU) admission or death. We evaluated baseline characteristics and MS therapies associated with severe COVID-19 by multivariate and propensity score (PS)-weighted ordinal logistic models. Sensitivity analyses were run to confirm the results. Results: Of 844 PwMS with suspected (n = 565) or confirmed (n = 279) COVID-19, 13 (1.54%) died; 11 of them were in a progressive MS phase, and 8 were without any therapy. Thirty-eight (4.5%) were admitted to an ICU; 99 (11.7%) had radiologically documented pneumonia; 96 (11.4%) were hospitalized. After adjusting for region, age, sex, progressive MS course, Expanded Disability Status Scale, disease duration, body mass index, comorbidities, and recent methylprednisolone use, therapy with an anti-CD20 agent (ocrelizumab or rituximab) was significantly associated (odds ratio [OR] = 2.37, 95% confidence interval [CI] = 1.18-4.74, p = 0.015) with increased risk of severe COVID-19. Recent use (<1 month) of methylprednisolone was also associated with a worse outcome (OR = 5.24, 95% CI = 2.20-12.53, p = 0.001). Results were confirmed by the PS-weighted analysis and by all the sensitivity analyses. Interpretation: This study showed an acceptable level of safety of therapies with a broad array of mechanisms of action. However, some specific elements of risk emerged. These will need to be considered while the COVID-19 pandemic persists