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THE FOLLOWING ATTEMPTS TO DEVELOP A POLITICAL CONCEPTION FOR THE OBJECTIVE CONNECTION BETWEEN THE GERMAN QUESTION AND THE SAFEGUARDING OF PEACE. THIS PAPER POSES THE GERMAN QUESTION IN RADICAL TERMS, I.E., IN TERMS OF NATIONAL SOVEREIGNTY AND THE RIGHT TO SELF-DETERMINATION, BASIC PRINCIPLES OF THE DEMOCRATIC "LEFT," WHICH MOREOVER ARE FUNDAMENTAL TO ANY THOUGHT CONCERNING EQUALITY AND EMANCIPATION VIS-A-VIS THE INTERNAL AND EXTERNAL STRUCTURES OF AUTHORITY AND RULE.

The objective of our work was to improve healthcare services supported by eHealth applications in sub-Saharan Africa (SSA) by proposing interoperability that is proportional, in terms of costs and benefits, to immediate demands and is capable to enable future scenarios of growth. (e)Health represents a very complex system with many stakeholders, services and technologies, varying objectives and forces that play out on separate hierarchical levels with inconsistent and sometimes even contradicting prerequisites as well as requirements. To provide individual patients with the integrated care they need and to meet the distinct however interrelated interests of the other primary stakeholders and society alike, interoperability guidance is required. To improve effectiveness and efficiency of eHealth in SSA, interoperability solutions that stimulate and consolidate cooperation on various levels (e.g., local, district, national, international) and in different dimensions (e.g., social and political, regulatory, organisational, technical, semantic, financial) is key. To that end, we have conducted research towards a flexible interoperability framework that can cope with various demands from these different levels and dimensions, and facilitates different operational models of cooperation while preserving interoperability. Since a top-down approach too often results in unworkable, one-size-fits-all paradigms, and a bottom-up approach generates heterogeneous, non-interoperable islands of operations, we propose a value-driven, hybrid approach with intense user involvement and incremental steps towards higher levels of interoperability. By building on successful initiatives on any level, with proven cooperative solutions in at least one dimension, and guiding further development by addressing dimensional issues at each level proportionally, interoperable centers of cooperative eHealth emerge that are governed by African ownership towards future growth, yet remain proportional to current demands and flexible to future scenarios.

The objective of our work was to improve healthcare services supported by eHealth applications in sub-Saharan Africa (SSA) by proposing interoperability that is proportional, in terms of costs and benefits, to immediate demands and is capable to enable future scenarios of growth. (e)Health represents a very complex system with many stakeholders, services and technologies, varying objectives and forces that play out on separate hierarchical levels with inconsistent and sometimes even contradicting prerequisites as well as requirements. To provide individual patients with the integrated care they need and to meet the distinct however interrelated interests of the other primary stakeholders and society alike, interoperability guidance is required. To improve effectiveness and efficiency of eHealth in SSA, interoperability solutions that stimulate and consolidate cooperation on various levels (e.g., local, district, national, international) and in different dimensions (e.g., social and political, regulatory, organisational, technical, semantic, financial) is key. To that end, we have conducted research towards a flexible interoperability framework that can cope with various demands from these different levels and dimensions, and facilitates different operational models of cooperation while preserving interoperability. Since a top-down approach too often results in unworkable, one-size-fits-all paradigms, and a bottom-up approach generates heterogeneous, non-interoperable islands of operations, we propose a value-driven, hybrid approach with intense user involvement and incremental steps towards higher levels of interoperability. By building on successful initiatives on any level, with proven cooperative solutions in at least one dimension, and guiding further development by addressing dimensional issues at each level proportionally, interoperable centers of cooperative eHealth emerge that are governed by African ownership towards future growth, yet remain proportional to current demands and flexible to future scenarios.

This work was supported by the World Cancer Research Fund (WCRF UK), as part of the World Cancer Research Fund International grant programme (WCRF 2014/1180 to Konstantinos K Tsilidis). The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ), Federal Ministry of Education and Research (BMBF),Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany); the Hellenic Health Foundation (Greece); Associazione Italiana per la Ricerca sul Cancro-AIRC-Italy and National Research Council (Italy); Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands); Health Research Fund (FIS), Instituto de Salud Carlos III (ISCIII), Regional Governments of Andalucía, Asturias, Basque Country, Murcia, Navarra, and the Catalan Institute of Oncology (Barcelona) (Spain); Swedish Cancer Society, Swedish Research Council and County Councils of Skåne and Västerbotten (Sweden); Cancer Research UK (14136 to EPIC-Norfolk; C570/A16491 and C8221/A19170 to EPIC-Oxford), Medical Research Council (1000143 to EPIC-Norfolk, MR/ M012190/1 to EPIC-Oxford) (UK). ; Heath, A.K., Muller, D.C., Van Den Brandt, P.A., Papadimitriou, N., Critselis, E., Gunter, M., Vineis, P., Weiderpass, E., Fagherazzi, G., Boeing, H., Ferrari, P., Olsen, A., Tjønneland, A., Arveux, P., Boutron-Ruault, M.-C., Mancini, F.R., Kühn, T., Turzanski-Fortner, R., Schulze, M.B., Karakatsani, A., Thriskos, P., Trichopoulou, A., Masala, G., Contiero, P., Ricceri, F., ...

Background Malaria is one of the major causes of childhood death in sub-Saharan countries. A reliable estimation of malaria prevalence is important to guide and monitor progress toward control and elimination. The aim of the study was to estimate the true prevalence of malaria in children under five in the Democratic Republic of the Congo, Uganda and Kenya, using a Bayesian modelling framework that combined in a novel way malaria data from national household surveys with external information about the sensitivity and specificity of the malaria diagnostic methods used in those surveys—i.e., rapid diagnostic tests and light microscopy. Methods Data were used from the Demographic and Health Surveys (DHS) and Malaria Indicator Surveys (MIS) conducted in the Democratic Republic of the Congo (DHS 2013–2014), Uganda (MIS 2014–2015) and Kenya (MIS 2015), where information on infection status using rapid diagnostic tests and/or light microscopy was available for 13,573 children. True prevalence was estimated using a Bayesian model that accounted for the conditional dependence between the two diagnostic methods, and the uncertainty of their sensitivities and specificities obtained from expert opinion. Results The estimated true malaria prevalence was 20% (95% uncertainty interval [UI] 17%–23%) in the Democratic Republic of the Congo, 22% (95% UI 9–32%) in Uganda and 1% (95% UI 0–3%) in Kenya. According to the model estimations, rapid diagnostic tests had a satisfactory sensitivity and specificity, and light microscopy had a variable sensitivity, but a satisfactory specificity. Adding reported history of fever in the previous 14 days as a third diagnostic method to the model did not affect model estimates, highlighting the poor performance of this indicator as a malaria diagnostic. Conclusions In the absence of a gold standard test, Bayesian models can assist in the optimal estimation of the malaria burden, using individual results from several tests and expert opinion about the performance of those tests.

36 pages, 12 figures, 1 table ; he tropical Atlantic is home to multiple coupled climate variations covering a wide range of timescales and impacting societally relevant phenomena such as continental rainfall, Atlantic hurricane activity, oceanic biological productivity, and atmospheric circulation in the equatorial Pacific. The tropical Atlantic also connects the southern and northern branches of the Atlantic meridional overturning circulation and receives freshwater input from some of the world's largest rivers. To address these diverse, unique, and interconnected research challenges, a rich network of ocean observations has developed, building on the backbone of the Prediction and Research Moored Array in the Tropical Atlantic (PIRATA). This network has evolved naturally over time and out of necessity in order to address the most important outstanding scientific questions and to improve predictions of tropical Atlantic severe weather and global climate variability and change. The tropical Atlantic observing system is motivated by goals to understand and better predict phenomena such as tropical Atlantic interannual to decadal variability and climate change; multidecadal variability and its links to the meridional overturning circulation; air-sea fluxes of CO2 and their implications for the fate of anthropogenic CO2; the Amazon River plume and its interactions with biogeochemistry, vertical mixing, and hurricanes; the highly productive eastern boundary and equatorial upwelling systems; and oceanic oxygen minimum zones, their impacts on biogeochemical cycles and marine ecosystems, and their feedbacks to climate. Past success of the tropical Atlantic observing system is the result of an international commitment to sustained observations and scientific cooperation, a willingness to evolve with changing research and monitoring needs, and a desire to share data openly with the scientific community and operational centers. The observing system must continue to evolve in order to meet an expanding set of research priorities and operational challenges. This paper discusses the tropical Atlantic observing system, including emerging scientific questions that demand sustained ocean observations, the potential for further integration of the observing system, and the requirements for sustaining and enhancing the tropical Atlantic observing system ; MM-R received funding from the MORDICUS grant under contract ANR-13-SENV-0002-01 and the MSCA-IF-EF-ST FESTIVAL (H2020-EU project 797236). GF, MG, RLu, RP, RW, and CS were supported by NOAA/OAR through base funds to AOML and the Ocean Observing and Monitoring Division (OOMD; fund reference 100007298). This is NOAA/PMEL contribution #4918. PB, MDe, JH, RH, and JL are grateful for continuing support from the GEOMAR Helmholtz Centre for Ocean Research Kiel. German participation is further supported by different programs funded by the Deutsche Forschungsgemeinschaft, the Deutsche Bundesministerium für Bildung und Forschung (BMBF), and the European Union. The EU-PREFACE project funded by the EU FP7/2007–2013 programme (Grant No. 603521) contributed to results synthesized here. LCC was supported by the UERJ/Prociencia-2018 research grant. JOS received funding from the Cluster of Excellence Future Ocean (EXC80-DFG), the EU-PREFACE project (Grant No. 603521) and the BMBF-AWA project (Grant No. 01DG12073C)