Kosovo - en tvivlsom proces

Forhandlinger om en ny stat i Europa er nu gået i gang, efter at det internationale samfund er besluttet på at få afklaret Kosovos fremtidige status. Så besluttet, at FN-rapporten, der banede vej for forhandlinger, ligner bestillingsarbejde.&nbsp

Aktivisme på tjekkisk

Tjekkiet fører sin helt egen aktivistiske udenrigspolitik, der er baseret på dissidenternes erfaring fra den kommunistiske fortid, og som derfor lægger afgørende vægt på støtte til demokratisering, især i tjekkiets nærområde.&nbsp

Kommentar: Tak dem som takkes bør

Thank Those Who Should Be ThankedDenmark has received much praise for the rescue of the Jews in 1943. In reality, however, Denmark cannot live up to the altruistic myth about a whole nation saving its Jewish population. There was a lot of money involved, which was paid to fishermen and middlemen. Also, regular conmen operated in the waters used for the escape.These darker circumstances of the escape have remained almost unmentioned for a long time. Only recently has the money issue been publicly discussed, among other things, because of a kind of false gratitude from the Jews in Denmark. The author argues that when taken into consideration that a period of 70 years has passed since the Nazi action against the Jews, it should be possible to distinguish between those who made money on people in distress and those who really deserve a thank you

Kosovo – når virkeligheden er svær at styre

Intet resum

Tryptophan 2,3-dioxygenase (TDO)-reactive T cells differ in their functional characteristics in health and cancer

Tryptophan-2,3-dioxygenase (TDO) physiologically regulates systemic tryptophan levels in the liver. However, numerous studies have linked cancer with activation of local and systemic tryptophan metabolism. Indeed, similar to other heme dioxygenases TDO is constitutively expressed in many cancers. In the present study, we detected the presence of both CD8(+) and CD4(+) T-cell reactivity toward TDO in peripheral blood of patients with malignant melanoma (MM) or breast cancer (BC) as well as healthy subjects. However, TDO-reactive CD4(+) T cells constituted distinct functional phenotypes in health and disease. In healthy subjects these cells predominately comprised interferon (IFN)γ and tumor necrosis factor (TNF)-α producing Th1 cells, while in cancer patients TDO-reactive CD4(+) T-cells were more differentiated with release of not only IFNγ and TNFα, but also interleukin (IL)-17 and IL-10 in response to TDO-derived MHC-class II restricted peptides. Hence, in healthy donors (HD) a Th1 helper response was predominant, whereas in cancer patients CD4(+) T-cell responses were skewed toward a regulatory T cell (Treg) response. Furthermore, MM patients hosting a TDO-specific IL-17 response showed a trend toward an improved overall survival (OS) compared to MM patients with IL-10 producing, TDO-reactive CD4(+) T cells. For further characterization, we isolated and expanded both CD8(+) and CD4(+) TDO-reactive T cells in vitro. TDO-reactive CD8(+) T cells were able to kill HLA-matched tumor cells of different origin. Interestingly, the processed and presented TDO-derived epitopes varied between different cancer cells. With respect to CD4(+) TDO-reactive T cells, in vitro expanded T-cell cultures comprised a Th1 and/or a Treg phenotype. In summary, our data demonstrate that the immune modulating enzyme TDO is a target for CD8(+) and CD4(+) T cell responses both in healthy subjects as well as patients with cancer; notably, however, the functional phenotype of these T-cell responses differ depending on the respective conditions of the host

Human impact of wild firewood species in the Rural Andes community of Apillapampa, Bolivia

Firewood is the basic fuel source in rural Bolivia. A study was conducted in an Andean village of subsistence farmers to investigate human impact on wild firewood species. A total of 114 different fuel species was inventoried during fieldtrips and transect sampling. Specific data on abundance and growth height of wild firewood species were collected in thirty-six transects of 50 x2 m(2). Information on fuel uses of plants was obtained from 13 local Quechua key participants. To appraise the impact of fuel harvest, the extraction impact value (EIV) index was developed. This index takes into account local participants' appreciation of (1) decreasing plant abundance; (2) regeneration capacity of plants; (3) impact of root harvesting; and (4) quality of firewood. Results suggest that several (sub-)woody plant species are negatively affected by firewood harvesting. We found that anthropogenic pressure, expressed as EIV, covaried with density of firewood species, which could entail higher human pressure on more abundant and/or more accessible species. The apparent negative impact of anthropogenic pressure on populations of wild fuel species is corroborated by our finding that, in addition to altitude, several anthropogenic variables (i.e. site accessibility, cultivation of exotics and burning practices) explain part of the variation in height of firewood species in the surroundings of Apillapampa

Low-dose hydrocortisone in patients with COVID-19 and severe hypoxia: The COVID STEROID randomised, placebo-controlled trial.

BACKGROUND In the early phase of the pandemic, some guidelines recommended the use of corticosteroids for critically ill patients with COVID-19, whereas others recommended against the use despite lack of firm evidence of either benefit or harm. In the COVID STEROID trial, we aimed to assess the effects of low-dose hydrocortisone on patient-centred outcomes in adults with COVID-19 and severe hypoxia. METHODS In this multicentre, parallel-group, placebo-controlled, blinded, centrally randomised, stratified clinical trial, we randomly assigned adults with confirmed COVID-19 and severe hypoxia (use of mechanical ventilation or supplementary oxygen with a flow of at least 10 L/min) to either hydrocortisone (200 mg/d) vs a matching placebo for 7 days or until hospital discharge. The primary outcome was the number of days alive without life support at day 28 after randomisation. RESULTS The trial was terminated early when 30 out of 1000 participants had been enrolled because of external evidence indicating benefit from corticosteroids in severe COVID-19. At day 28, the median number of days alive without life support in the hydrocortisone vs placebo group were 7 vs 10 (adjusted mean difference: -1.1 days, 95% CI -9.5 to 7.3, P = .79); mortality was 6/16 vs 2/14; and the number of serious adverse reactions 1/16 vs 0/14. CONCLUSIONS In this trial of adults with COVID-19 and severe hypoxia, we were unable to provide precise estimates of the benefits and harms of hydrocortisone as compared with placebo as only 3% of the planned sample size were enrolled. TRIAL REGISTRATION ClinicalTrials.gov: NCT04348305. European Union Drug Regulation Authorities Clinical Trials (EudraCT) Database: 2020-001395-15

Restriction of Intravenous Fluid in ICU Patients with Septic Shock.

BACKGROUND Intravenous fluids are recommended for the treatment of patients who are in septic shock, but higher fluid volumes have been associated with harm in patients who are in the intensive care unit (ICU). METHODS In this international, randomized trial, we assigned patients with septic shock in the ICU who had received at least 1 liter of intravenous fluid to receive restricted intravenous fluid or standard intravenous fluid therapy; patients were included if the onset of shock had been within 12 hours before screening. The primary outcome was death from any cause within 90 days after randomization. RESULTS We enrolled 1554 patients; 770 were assigned to the restrictive-fluid group and 784 to the standard-fluid group. Primary outcome data were available for 1545 patients (99.4%). In the ICU, the restrictive-fluid group received a median of 1798 ml of intravenous fluid (interquartile range, 500 to 4366); the standard-fluid group received a median of 3811 ml (interquartile range, 1861 to 6762). At 90 days, death had occurred in 323 of 764 patients (42.3%) in the restrictive-fluid group, as compared with 329 of 781 patients (42.1%) in the standard-fluid group (adjusted absolute difference, 0.1 percentage points; 95% confidence interval [CI], -4.7 to 4.9; P = 0.96). In the ICU, serious adverse events occurred at least once in 221 of 751 patients (29.4%) in the restrictive-fluid group and in 238 of 772 patients (30.8%) in the standard-fluid group (adjusted absolute difference, -1.7 percentage points; 99% CI, -7.7 to 4.3). At 90 days after randomization, the numbers of days alive without life support and days alive and out of the hospital were similar in the two groups. CONCLUSIONS Among adult patients with septic shock in the ICU, intravenous fluid restriction did not result in fewer deaths at 90 days than standard intravenous fluid therapy. (Funded by the Novo Nordisk Foundation and others; CLASSIC ClinicalTrials.gov number, NCT03668236.)