Were the Brits Swiss, they would still have voted to leave

On the referendum day these were last minute decisions that most probably turned the tide in favour of the Leave camp. In this article Thomas Milic and Uwe Serdült draw up an analogy of the June 23rd vote between the referendum votes on the EU that took place in Switzerland over the past couple of years. They argue that would the Brits be Swiss, they would have voted for an exit as well

Shielding Considerations for CubeSat Structures During Solar Maximum

The purpose of this lessons learned paper is to communicate the utility of shielding in small spacecraft planning for the support of mission assurance and reliability. Numerous SmallSats have been flying in polar low Earth orbit for science, communications, technology demonstrations, and imaging with academic, commercial, and government interests. Shielding has been part of mission assurance and reliability from the advent of long duration spacecraft missions. The Shields-1 CubeSat has been operating in polar low Earth orbit since 16 December 2018 with atomic number (Z)-grade radiation shielding and demonstrates shielding effectiveness. Shields-1 has collected a representative example of solar minimum data in 2019 with 8 Teledyne uDosimeters over varying shielding effectivenesses. It serves as current experimental data and has been compared with NOVICE Shielding estimates using the AP8 – AE8 trapped radiation model with the Shields-1 CAD and generic CubeSat 3 unit (U) models. Using NOVICE model radiation analysis coding, the shielding effectivenesses, based on a generic CubeSat 3U structure with 4 electronic boards, were estimated for aluminum wall thicknesses ranging from 0.204-cm to 4.44-cm (0.550-g/cm2 – 12.0-g/cm2) thick aluminum. For modeled polar orbiting spacecraft, solar maximum total ionizing dose (TID) increases by nearly a magnitude for thin-walled aluminum 0.550-g/cm2 - 0.686-g/cm2 (0.204-cm – 0.254-cm) typical CubeSat structures. The shielding effectiveness by NOVICE Sigma estimates, which is a shielding sphere approximation around a detector, showed a linear relationship with wall thickness, which increased over the wall thickness by a ratio of 1.43 determined by linear regression analysis. Using NOVICE Adjoint Monte-Carlo Modeling of solar minimum and solar maximum with the inclusion of a worst-case solar particle event over a 1-year mission without geomagnetic shielding, the TID for minimum and maximum conditions for a generic 3U with a wall thickness of 0.254 cm is 158 RAD and 1540 RAD, respectively. The modeled total solar maximum TID is over estimated, because at low orbital latitudes a spacecraft will have shielding from the Earth’s magnetic field. However, TID will still be significant at high latitudes over the poles, where a spacecraft is exposed in a solar particle event. In contrast, to a thin-walled generic 3U CubeSat, the Shields-1 electronics enclosure has a shielding effectiveness of 21.3 g/cm2 from NOVICE Sigma modeling and is expected to show reduced total ionizing dose increases during the present active Solar Cycle 25 period. Because solar particle events during solar maximum increase TID on electronic parts with thin-walled shielding in short periods of time, it is a mission assurance and reliability consideration on the spacecraft’s mission value versus adding shielding for risk reduction of premature spacecraft or instrument payload loss. Since the volumes of many instruments and system electronics have reduced with small spacecraft, shielding material costs and weight penalties have diminished. A small spacecraft project budget and schedule may limit traditional radiation-hardened part use and radiation testing requirements, where shielding can contribute to mission assurance and reliability with reduced costs

Thrombotic and bleeding complications in patients with chronic lymphocytic leukemia and severe COVID-19: a study of ERIC, the European Research Initiative on CLL

Edad; Terapia anticoagulante; HemorragiaEdat; Teràpia anticoagulant; HemorràgiaAge; Anticoagulant therapy; HaemorrhageBackground: Patients with chronic lymphocytic leukemia (CLL) may be more susceptible to COVID-19 related poor outcomes, including thrombosis and death, due to the advanced age, the presence of comorbidities, and the disease and treatment-related immune deficiency. The aim of this study was to assess the risk of thrombosis and bleeding in patients with CLL affected by severe COVID-19. Methods: This is a retrospective multicenter study conducted by ERIC, the European Research Initiative on CLL, including patients from 79 centers across 22 countries. Data collection was conducted between April and May 2021. The COVID-19 diagnosis was confirmed by the real-time polymerase chain reaction (RT-PCR) assay for SARS-CoV-2 on nasal or pharyngeal swabs. Severe cases of COVID-19 were defined by hospitalization and the need of oxygen or admission into ICU. Development and type of thrombotic events, presence and severity of bleeding complications were reported during treatment for COVID-19. Bleeding events were classified using ISTH definition. STROBE recommendations were used in order to enhance reporting. Results: A total of 793 patients from 79 centers were included in the study with 593 being hospitalized (74.8%). Among these, 511 were defined as having severe COVID: 162 were admitted to the ICU while 349 received oxygen supplementation outside the ICU. Most patients (90.5%) were receiving thromboprophylaxis. During COVID-19 treatment, 11.1% developed a thromboembolic event, while 5.0% experienced bleeding. Thrombosis developed in 21.6% of patients who were not receiving thromboprophylaxis, in contrast to 10.6% of patients who were on thromboprophylaxis. Bleeding episodes were more frequent in patients receiving intermediate/therapeutic versus prophylactic doses of low-molecular-weight heparin (LWMH) (8.1% vs. 3.8%, respectively) and in elderly. In multivariate analysis, peak D-dimer level and C-reactive protein to albumin ratio were poor prognostic factors for thrombosis occurrence (OR = 1.022, 95%CI 1.007‒1.038 and OR = 1.025, 95%CI 1.001‒1.051, respectively), while thromboprophylaxis use was protective (OR = 0.199, 95%CI 0.061‒0.645). Age and LMWH intermediate/therapeutic dose administration were prognostic factors in multivariate model for bleeding (OR = 1.062, 95%CI 1.017-1.109 and OR = 2.438, 95%CI 1.023-5.813, respectively). Conclusions: Patients with CLL affected by severe COVID-19 are at a high risk of thrombosis if thromboprophylaxis is not used, but also at increased risk of bleeding under the LMWH intermediate/therapeutic dose administration

Direktwahl der Regierung. Beispiele, Szenarien, Machbarkeit. Liechtenstein-Institut

Im Auftrag der Regierung erstellte das Liechtenstein-Institut eine Studie zu einer möglichen Direktwahl der Regierung. Der Auftrag geht zurück auf ein Postulat der DpL-Abgeordneten aus dem Jahr 2019. Der Landtag hatte das Postulat im März 2020 an die Regierung überwiesen. Mit dem Postulat wurde die Regierung beauftragt abzuklären, welche Auswirkungen die Einführung der Direktwahl der Regierung mit sich bringen würde. Insbesondere sollten verschiedene Varianten der Direktwahl der Regierung einander gegenübergestellt und deren Vor- und Nachteile beleuchtet werden. Um die gestellten Fragen beantworten zu können, werden das Regierungssystem Liechtensteins dargestellt und zum Vergleich die verschiedenen Modelle der Wahl der Exekutiven der Schweizer Kantone erörtert. Anschliessend werden verschiedene Reformszenarien präsentiert. Nach einer Präsentation derjenigen Verfassungs- und Gesetzesbestimmungen, die abgeändert werden müssten und entsprechenden Formulierungsvorschlägen, erfolgt eine Auseinandersetzung mit Vor- und Nachteilen sowie offenen Fragen der verschiedenen möglichen Varianten

Two-Tier Care Pathways for Liver Fibrosis Associated to Non-Alcoholic Fatty Liver Disease in HIV Mono-Infected Patients

(1) Background: Developing strategies to identify significant liver fibrosis in people with HIV (PWH) is crucial to prevent complications of non-alcoholic fatty liver disease (NAFLD). We aim to investigate if five simple serum biomarkers applied to PWH can optimize a care pathway to identify significant liver fibrosis defined by transient elastography (TE). (2) Methods: A two-tier fibrosis pathway was applied to three prospective cohorts of PWH undergoing TE with CAP. NAFLD was diagnosed as a controlled attenuation parameter ≥ 248 dB/m. Five simple fibrosis biomarkers (FIB-4 < 1.3, BARD score 0–1, NAFLD fibrosis score < −1.455, AST:ALT ratio < 0.8 and APRI < 0.5) were applied as first-tiers to exclude significant liver fibrosis. We determined the decrease in referral for TE that would have occurred based on biomarker assessment and the discordance between low simple fibrosis biomarkers and high TE (≥7.1 kPa), indicating significant liver fibrosis. (3) Results: Of the 1749 consecutive PWH, 15.1% had significant liver fibrosis by TE and 39.1% had NAFLD. The application of the fibrosis biomarkers as first tiers would have resulted in a decrease in TE referrals between 24.9% (BARD score) and 86.3% (APRI). The lowest discordance rate was with NAFLD fibrosis score (8.5%). After adjustments, BMI (odds ratio (OR) 1.12, 95% CI: 1.08–1.17) and triglycerides (OR 1.26, 95% CI: 1.11–1.44) were independent predictors of discordance for APRI < 0.5 and TE ≥ 7.1. The performance of the two-tier pathways was similar in PWH with and without NAFLD. (4) Conclusions: Implementing a two-tier pathway could save a substantial proportion up of TE examinations, reducing costs and helping resource optimization in HIV care. Patients with metabolic risk factors for NAFLD and low fibrosis biomarker may still be considered for TE referral