Abstract Whilst the European Union's (EU's) response to health emergencies has historically been subpar, some suggest that it emerged from COVID‐19 as a stronger global health actor. This prompts two ...interrelated questions: how have International Relations scholars conceptualised and assessed EU ‘actorness’ in the all‐too‐often neglected field of global health, and what adjustments are required in anticipation of a potential new age of pandemics? This article revisits the longstanding notion of ‘actorness’ and dissects the few studies that apply it systematically to analyse the EU's role in global health. After identifying some key shortcomings in the literature, the article formulates a research agenda suitable for the complex and high‐stakes nature of contemporary global health endeavours. By further adapting the concept of ‘actorness’ to a multifaceted EU external action as well as to an increasingly intricate global governance architecture, this research agenda contributes to the broader scholarship on the EU's international outreach.
From the time Sativex (THC:CBD) oromucosal spray first became available in European Union countries in 2010 for the management of treatment-resistant multiple sclerosis (MS) spasticity, data from ...daily practice have been collected through various projects.
A retrospective registry study and a prospective safety study of THC:CBD oromucosal spray are reported.
The most recent analysis of a retrospective registry established in the United Kingdom (UK), Germany and Switzerland, which collected safety data on more than 900 patients, has indicated a positive risk-benefit profile for THC:CBD oromucosal spray during long-term use. Long-term continuation rates were 68% (mean follow-up time 1 year) and the mean dose was 5.4 sprays/day. No new safety concerns were identified, and adverse events of special interest for a cannabis-based medicine were limited. The UK registry has since been closed but remains open in Germany and Switzerland. A prospective safety study undertaken in Spain involved 207 patients from 13 specialized MS centres who had been prescribed THC:CBD oromucosal spray. The findings aligned closely with the UK/German/Swiss registry data in terms of 1-year continuation rates (64.7%), mean daily dose (6.6 sprays/day) and safety profile, including no evidence of addiction, abuse or misuse.
The homogeneity between these observational studies supports the interest in THC:CBD oromucosal spray for management of MS spasticity in daily practice.
Aggressive, highly active, or rapidly evolving severe relapsing-remitting multiple sclerosis (RRMS) is characterized by frequent relapses and active disease on magnetic resonance imaging, ultimately ...leading to a high risk for rapid disability accumulation. The treatment approach for high-risk patients is evolving into a model of individualized therapy in which early initiation of high-efficacy disease-modifying therapy (DMT), which I refer to as “early and strong” therapy, is viewed as a rational strategy to prevent the irreversible damage that occurs at disease onset and early in the disease course. This approach uses an individualized benefit-risk assessment to match the level of DMT efficacy with the patient's risk of disease progression and balances it against the risk of drug-related adverse events. It also includes consideration of the patient's risk tolerance and desire for a high-efficacy treatment. This paper discusses the rationale for early treatment, and summarizes the available clinical data on high-efficacy and moderately-high efficacy DMTs in patients with high-risk RRMS.
Literature searches were conducted using search terms “aggressive RRMS”, “highly active RRMS”, and “severe RRMS” alone and in conjunction with the terms “natalizumab”, “fingolimod”, “alemtuzumab”, “mitoxantrone”, and “cyclophosphamide”. Studies of drug efficacy in these high-risk populations were reviewed.
Subgroup analyses of pivotal trials of natalizumab, fingolimod, and alemtuzumab were available, as well as an independent study of mitoxantrone and a pilot study of cyclophosphamide. In each study, DMT reduced relapses versus either placebo, active comparator, or baseline relapse rate.
Data for the high-efficacy DMTs natalizumab and alemtuzumab, and the moderately high-efficacy DMT fingolimod, suggest they are effective in this patient population. Further studies are warranted, and clinical trial data to inform treatment decisions for this high-risk group represent a significant unmet need.
•High RRMS disease activity increases risk for rapid disability accumulation.•High-efficacy DMTs allow initiation of “early and strong” therapy in these patients.•Subgroup data from high-efficacy DMT trials suggest benefit in high-risk patients.
En este trabajo se analiza la tesis foucaultiana de la reducción de la filosofía a forma de conocimiento en Descartes y el consecuente abandono de la espiritualidad clásica, es decir, de la filosofía ...concebida como forma de vida basada en el cuidado de sí. A partir de aquí, además de observar que el propio Foucault matizará esta tesis, se demostrará que en Descartes la filosofía sigue esencialmente unida a la espiritualidad.
Se analiza la lectura que Maria Zambrano realiza del estoicismo entre los ahos 1937 y 1958, prestando atencion a los cambios que se producen en dicha lectura y al valor que la autora otorga al ...estoicismo, especialmente en su vertiente senequista, como herramienta para comprender la circunstanciaespaholay europeaen aquellos ahos. Ademas, se defiende la relevancia de la lectura zambraniana del estoicismo a traves de su comparacion con la realizada por Michel Foucault. Uno de los resultados mas interesantes de esta comparacion ha sido el descubrimiento del potencial de la filosoffa de Zambrano para intervenir productivamente en el debate contemporaneo en torno al humanismo, aportando argumentos para una defensa renovada y critica del humanismo con respecto a los postulados antihumanistas que el propio Foucault formulo.
The pandemic caused by the spread of Covid-19 is giving rise to an exceptional social situation because of the great speed of propagation of the illness and the high level of mortality it has ...occasioned in a very short time. Moreover, the lockdown measures decreed in Spain prohibit the holding of wakes to avoid contagion, and limit funerals to three people plus the officiant. Thus, coronavirus is robbing people of the opportunity of a final farewell, stripping the dead of their dignity and worsening the grief of the living. This article investigates the situation and the social and cultural impact it has provoked. The method used takes the line of critical dialogue analysis (CDA) applied to information contained in the mass media, employing qualitative material from a related small-scale study. The results show that in countries like Spain where there is a strong Roman Catholic tradition the importance of these rituals is unquestionable. Although the country has become laicized over recent years, many traditions around death are still maintained. Hence, the impossibility of holding funerals is triggering a large number of social and personal conflicts. Furthermore, they indicate that lockdown, and the lack of rituals and of accompaniment constitute some of the most crucial stressors in the epidemic. Grief in solitude has become widespread and all the more fundamental in a society that values social support from close friends and family members. The conclusions show that the social distancing imposed by the epidemic is especially hard to bear when relatives are passing into death.
This work analyzes six quartos described by ISTAE (Quartos of Spanish Classical Theater) preserved in the BNE that show a series of common orthotypographical features: the pagination, the title, the ...COMEDIA/FAMOSA structure,
the name of the author, The following persons speak in it, the dramatis personae
in three columns, the horizontal fillet, the chapter mark, the initial stage direction.
They all appear to be from the first half of the seventeenth century. After describing
them and briefly pointing out the importance of these quartos for the textual transmission of these comedies, I compare the fonts and I propose the possibility that
they came from the workshop of the printer Simón Fajardo, who worked in Seville
between at least 1622 and 1650
Este trabajo analiza seis comedias sueltas descritas en ISTAE (Impresos sueltos del teatro antiguo español) conservadas en la BNE que muestran una serie de rasgos ortotipográficos comunes, que se detallan: la paginación, el título, el COMEDIA/ FAMOSA, el nombre del autor, Hablan en ella las personas siguientes, las dramatis personae en tres columnas, el filete horizontal, la marca de jornada, la acotación inicial. Todas parecen ser de la primera mitad del siglo XVII. Tras describirlas y señalar someramente la importancia que tienen estas sueltas para la transmisión textual de estas comedias, se comparan tipografías y se aventura la posibilidad de que salieran del taller del impresor Simón Fajardo, quien trabajó en Sevilla entre, al menos, 1622 y 1650.
Neuromyelitis Optica and Multiple Sclerosis are idiopathic inflammatory demyelinating diseases of the central nervous system that currently are considered distinct autoimmune diseases, so differences ...in genetic susceptibility would be expected. This study aimed to investigate the HLA association with Neuromyelitis Optica by a systematic review with meta-analysis. The STROBE instrument guided research paper assessments. Thirteen papers published between 2009 and 2020 were eligible. 568 Neuromyelitis Optica patients, 41.4% Asians, 32.4% Latin Americans and 26.2% Europeans were analyzed. Only alleles of the DRB1 locus were genotyped in all studies. Neuromyelitis Optica patients have 2.46 more chances of having the DRB1*03 allelic group than controls. Ethnicity can influence genetic susceptibility. The main HLA association with Neuromyelitis Optica was the DRB1*03:01 allele in Western populations and with the DPB1*05:01 allele in Asia. Differences in the Multiple Sclerosis and Neuromyelitis Optica genetic susceptibility was confirmed in Afro descendants. The DRB1*03 allelic group associated with Neuromyelitis Optica has also been described in other systemic autoimmune diseases.
De entre las arquitecturas brutalistas que se apoyaron en la formalización exterior de las circulaciones como parte de su lenguaje escultórico, destaca el Edificio experimental en Malecón y F en La ...Habana (Edificio Girón, 1967) de Antonio Quintana Simonetti y Alberto Rodríguez Surribas. Coetáneo —incluso anterior— a planteamientos europeos análogos, este edificio de viviendas se convirtió en el primer gran experimento de la arquitectura moderna en Cuba y abrió el camino a la modernización del país tras el triunfo de la Revolución. Un edificio tan pionero como poco conocido, sobre el que apenas existen reseñas bibliográficas y el acceso a la documentación no ha sido posible y que amenaza ruina. El texto que sigue encuadra y ofrece una visión analítica y crítica del Edificio Girón a través de documentación gráfica inédita elaborada a partir de un levantamiento realizado in situ, con un doble objetivo: por un lado, la lectura de una arquitectura revolucionaria en donde la máquina provoca una configuración espacial atípica, cuyo lenguaje y resultado final terminan por sublimar la idea que vio nacer el proyecto sin suplantar a la arquitectura; por otro lado, la necesidad de perpetuar —ante el alto grado de deterioro que presenta el edificio— y la escasez de fuentes, el legado de su arquitectura, contextualizando las decisiones de proyecto con las ideas surgidas desde la Revolución, las influencias europeas y de los CIAM y su dialéctica con la tradición arquitectónica cubana, la aparición de la tecnología y la decidida apuesta de sus creadores.
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