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OBJECTIVE: Through a literature review, make recommendations regarding immunizations in people living with Inborn Error of Metabolism (IEM) in Brazil, assess the possible impact on metabolic decompensations after immunization, and if this specific population may have an impaired immune response to vaccines. SOURCE OF DATA: The MeSH Terms vaccination OR vaccine OR immunization associated with the term inborn error of metabolism AND recommendation were used in combination with search databases. Only articles published after 1990, in the languages English, Spanish, French or Portuguese, human-related were included. SYNTHESIS OF DATA: A total of 44 articles were included to make the following recommendations. Individuals with IEMs need to be up to date with their immunizations. Regarding which vaccines should be offered, children and adults should follow the routine immunization schedules locally available, including the COVID-19 vaccines. The only exception is the rotavirus vaccine for hereditary fructose intolerance. The benefit of immunization outweighs the very low risk of metabolic decompensation. Since not all patients will have an adequate immune response, measuring antibody conversion and titers is recommended CONCLUSIONS: All patients should receive age-appropriate immunizations in their respective schedules without delays. The only situation when vaccination may be contraindicated is with oral rotavirus vaccine in hereditary fructose intolerance. Monitoring the levels of antibodies should be done to detect any immune dysfunction or the necessity for boosters. A personalized immunization schedule is ideal for patients with IEMs. The reference organizations could improve their recommendations to address all IEMs, not only some of them.

Sirtuins are NAD

Abstract: Cognitive impairment is a prominent symptom of the post-COVID syndrome (PCS). However, the correspondence between subjective cognitive complaints (SCC) and objective results is inconsistent. Here, we investigated this discrepancy. This longitudinal study included N = 42 individuals who reported SCC as PCS after mild infection at inclusion. Data collection comprised questionnaires and neuropsychological assessment at baseline and follow-up (FU). At FU – on average 15 months after acute COVID-19 – 88 % of patients reported persisting SCC. There was an approx. 40 % discrepancy between subjective report and test results at both visits. Patients with SCC and objective impairment indicated elevated fatigue and reduced quality of life compared to patients without SCC at FU. A growing number of patients is anticipated to request neuropsychological assessments even after mild infections.

An approach relying on nanocavity confinement is developed in this paper for the sizing of nanoscale particles and single biomolecules in solution. The approach, termed nanocavity diffusional sizing (NDS), measures particle residence times within nanofluidic cavities to determine their hydrodynamic radii. Using theoretical modeling and simulations, we show that the residence time of particles within nanocavities above a critical time scale depends on the diffusion coefficient of the particle, which allows the estimation of the particle's size. We demonstrate this approach experimentally through the measurement of particle residence times within nanofluidic cavities using single-molecule confocal microscopy. Our data show that the residence times scale linearly with the sizes of nanoscale colloids, protein aggregates, and single DNA oligonucleotides. NDS thus constitutes a new single molecule optofluidic approach that allows rapid and quantitative sizing of nanoscale particles for potential applications in nanobiotechnology, biophysics, and clinical diagnostics.

IntroductionHigh alcohol availability is related to increased alcohol consumption and harms. Existing quantitative research provides potential explanations for this relationship but there is little understanding of how people experience local alcohol availability. This is the first review to synthesise qualitative research exploring the relationship between alcohol availability and other factors in local alcohol environments.MethodsThe scoping review includes qualitative studies exploring community-level alcohol availability and other factors, facilitating the purchase and consumption of alcohol. We included studies focusing on children and adolescents as well as adults. Study findings were brought together using thematic analysis and the socio-environmental context model, which explains how certain environments may facilitate drinking.ResultsThe review includes 34 articles. The majority of studies were conducted since 2012. Most studies were conducted in the United Kingdom, Australia and South Africa. The physical availability of alcohol and proximity to local amenities and temporal aspects, like late night opening hours, may be linked to social factors, such as normalisation of drinking and permissive drinking environments. The review highlights the importance of social and cultural factors in shaping interactions with local alcohol environments.Discussion and ConclusionThis qualitative scoping review advances understanding of the pathways linking alcohol availability and alcohol harms by showing that availability, accessibility and visibility of alcohol may contribute towards permissive drinking environments. Further research is needed to better understand how people experience alcohol availability in their local environment and how this can inform alcohol control policies.

Background. The COVID-19 pandemic has an impact on the incidence of type 1 diabetes and frequency of diabetic ketoacidosis. However, the exact relationships are unclear. It is also not known whether this is a short-term phenomenon or whether the effects have long-term relevance. Furthermore, it is not known whether these changes during the pandemic are due to direct effects of SARS-CoV-2 or to changes in the patient’s environment during the pandemic. Methods. We conducted an extensive literature search on PubMed. For the estimation of relative risks of new-onset type 1 diabetes, we applied a Poisson regression model and for the comparison of incidences and we included the logarithm of person-years. Furthermore, we performed a meta-analysis using the logarithm of the relative risk for new-onset type 1 diabetes as effect size. Results. Pooling the relative risk estimates in a random-effects meta-analysis revealed that the type 1 diabetes incidence rate increased by 20% (relative risk 1.200 (95% CI 1.125, 1.281)), and that the risk of new-onset type 1 diabetes after a SARS-CoV-2 infection increased by 62% (relative risk 1.622 (95% CI 1.347, 1.953)) compared with the prepandemic period. Conclusion. There is considerable evidence that there is an increase in type 1 diabetes in children during the COVID-19 pandemic. Many studies suggesting a direct effect of SARS-CoV-2 have methodological weaknesses. As no evidence of an increase in presymptomatic cases with isolated islet autoimmunity was found, this could also suggest an accelerated transition from presymptomatic patients to clinically overt type 1 diabetes. Furthermore, there was a marked exacerbation of the preexisting increase in the prevalence of diabetic ketoacidosis at diagnosis of type 1 diabetes during the pandemic. Both the increased incidence of paediatric type 1 diabetes and the higher prevalence of diabetic ketoacidosis at diagnosis led to a massive rise in the number of children with diabetic ketoacidosis during the pandemic.

High-risk groups, including Indigenous people, are at risk of severe COVID-19. Here we found that Australian First Nations peoples elicit effective immune responses to COVID-19 BNT162b2 vaccination, including neutralizing antibodies, receptor-binding domain (RBD) antibodies, SARS-CoV-2 spike-specific B cells, and CD4+ and CD8+ T cells. In First Nations participants, RBD IgG antibody titers were correlated with body mass index and negatively correlated with age. Reduced RBD antibodies, spike-specific B cells and follicular helper T cells were found in vaccinated participants with chronic conditions (diabetes, renal disease) and were strongly associated with altered glycosylation of IgG and increased interleukin-18 levels in the plasma. These immune perturbations were also found in non-Indigenous people with comorbidities, indicating that they were related to comorbidities rather than ethnicity. However, our study is of a great importance to First Nations peoples who have disproportionate rates of chronic comorbidities and provides evidence of robust immune responses after COVID-19 vaccination in Indigenous people.

External surges are a key component of extreme water levels in the North Sea. Caused by low-pressure cells over the North Atlantic and amplified at the continental shelf, they can drive water-level changes of more than 1 m at the British, Dutch and German coasts. This work describes an improved and semi-automated method to detect external surges in sea surface time histories. The method is used to analyse tide gauge and meteorological records from 1995 to 2020 and to supplement an existing dataset of external surges, which is used in the determination of design heights of coastal protection facilities. Furthermore, external surges are analysed with regard to their annual and decadal variability, corresponding weather conditions, and their interaction with storm surges in the North Sea. A total of 33 % of the 101 external surges occur within close succession of each other, leading to the definition of serial external surges, in which one or more external surges follow less than 72 h after the previous external surge. These serial events tend to occur more often during wind-induced storm surges. Moreover, the co-occurrence with a storm surge increases the height of an external surge by 15 % on average, highlighting the importance of the consideration of combined events in coastal protection strategies. The improved dataset and knowledge about serial external surges extend the available basis for coastal protection in the North Sea region.

In this article, the results of a survey of early career teachers on their experience with and perception mentorship during their first year of teaching are examined using a quantitative approach. A total of 100 early career teachers (80% female) of which 43 taught at primary school level participated in the study. Half of those surveyed agreed that mentors should be implemented during the induction phase. Primary school teachers, however, were less likely to not need any further mentoring to improve their quality of teaching beyond the induction phase (p=0.028; p=0.007). In general participants rated the mentoring relationship as a particularly trusting collegial and exemplary supportive working relationship. Nevertheless, more primary school teachers considered their mentors to be motivated for carrying out their task compared to secondary school mentees (p=0.036). Half of the respondents already recognized a personal learning success or further development process through the mentoring process in the induction phase. Taken together these results provide initial insights into the benefits of a mentoring process for novice teachers during their first year and highlight some benefits along with some concerns regarding this process.

Digital media are becoming increasingly influential in society, especially among the younger generation. Therefore, an augmented reality (AR) app was developed that simulates experiments with radioactive sources. The app runs experiments on the range and penetration power of alpha, beta and gamma radiation. It assigns virtual radiation sources, shielding materials or a detector to printed image markers, and superimposes their 3D images on the camera image. Alpha, beta and gamma radiation are clearly distinguishable by choosing different visualizations. The detector displays the measured count rates. At school, the app can be used in different ways. A concept for a teaching unit in Grade 10 was developed and tested in several classes based on a prototype of the app. The learning progress from the AR experiments was examined. Furthermore, an evaluation of the app was carried out. The most recent version of the app can be found here: https://seafile.projekt.uni-hannover.de/d/dd033aaaf5df4ec18362/

The optimal Reynolds-Averaged-Navier Stokes (RANS) turbulence model to be used in a Computational Fluid Dynamics (CFD) simulation varies depending on the application. Conventionally, the model is selected from benchmark tests and experience, but its performance is difficult to predict. For this reason, this study presents a cost-effective CFD validation routine, which uses three-dimensional experimental velocity data obtained in replicas of the specific flow system. Magnetic Resonance Velocimetry (MRV) is used as the measurement technique. Since the objective is only the validation of the turbulence model, the experiment and the simulation are performed with simplified flow conditions, hence, stationary iso-thermal iso-volumetric flow without inertial forces. The routine applies a data matching routine to align the two three-dimensional data sets before they are interpolated on a common grid. Various error metrics are presented, which provide the degree of the CFD modelling error and indicate its source. For demonstration, the validation routine is used to evaluate RANS-CFD results of a three-pass internal cooling system of a high-pressure turbine airfoil used in a small industrial gas turbine. The simulations are performed with the eddy-viscosity based turbulence model k-w SST and the Reynolds-Stress SSG, and BSL-EARSM turbulence models. The results indicate strong local errors in the examined turbulence models. None of the models performed well enough, underlining that every RANS-CFD application needs to be validated.

Patients with chronic lymphocytic leukemia (CLL) treated with B-cell pathway inhibitors and anti-CD20 antibodies exhibit low humoral response rates following SARS-CoV-2 vaccination. To investigate this observation, a prospective single-institution study was conducted comparing peripheral blood mononuclear cell transcriptional response with antibody and T-cell response rates following heterologous BNT162b2/ChAdOx1 vaccination of 15 patients with CLL/small lymphocytic lymphoma (SLL). Two-dose antibody response rate was 40%, increasing to 53% after booster. Patients on Bruton tyrosine kinase inhibitor (BTKi) and venetoclax ± anti-CD20 antibody within 12 months of vaccination responded inferiorly compared with those under BTKi alone. The 2-dose–T-cell response rate was 80%, which increased to 93% after the booster dose. Key transcriptional findings were that interferon–mediated signaling activation including activation of the JAK-STAT pathway generally occurred within days of vaccination, but was independent from the magnitude of the antibody response. Increasing counts of IGHV genes were associated with B-cell reconstitution and improved humoral response rate in the vaccinated patients. T-cell responses in patients with CLL appeared independent of treatment status, whereas higher humoral response rate was associated with BTKi treatment and B-cell reconstitution. Boosting was particularly effective when intrinsic immune status was improved by CLL treatment. Limitations included studying a relatively small cohort, with different treatments and vaccination schedules.

ZUSAMMENFASSUNGDie Hypophosphatasie (HPP) ist eine seltene genetische Erkrankung, welche infolge einer verminderten Alkalischen Phosphatase-Aktivität zu Problemen an Knochen, Muskeln, Zähnen, aber auch zahlreichen weiteren Organsystemen führen kann. Letztlich handelt es sich um eine metabolische Multisystemerkrankung mit sehr variablem klinischem Phänotyp bzw. Schweregrad, die alle Altersgruppen betreffen kann und zu einer signifikanten Mortalität und Morbidität bei den betroffenen Familien führt. Die klinische Verdachtsdiagnose kann durch laborchemische Untersuchungen (insbesondere die Bestimmung der AP-Aktivität), bildgebende Maßnahmen und eine humangenetische Testung erhärtet werden. Eine Anbindung betroffener Familien an ein erfahrenes Zentrum mit multidisziplinärer Betreuung erscheint sinnvoll. Die Enzymersatztherapie mit Asfotase alfa stellt eine zugelassene effektive und gut verträgliche Therapie zur Behandlung des „Knochenphänotyps“ dar. Langzeitdaten zu Wirksamkeit und Verträglichkeit sollen im Rahmen eines internationalen Registers erfasst werden.

The Schönberg-Höhlensystem (SBH) is not only the longest cave system in the Eastern Alps (length 156 km, depth 1061 m), but a significant proportion of the passages have developed on or just below two surfaces that dip 1.7° to the NE. These so-called "speleogenetic phases" are rarely developed in caves of the Northern Calcareous Alps and have not yet been confirmed by detailed morphological mapping. Furthermore, the deep parts of the cave offer the possibility to study the active epiphreatic zone for a distance of 1.6 km. Detailed morphological mapping shows that the main level at about 1500 m a.s.l. and a second 140 m higher developed as distinct speleogenetic phases, and the dip of the planes to the NE is consistent with palaeo-flow. Isolated vadose trenches formed at saddle points are further evidence. Correlations with other caves at similar altitudes suggest an Upper Miocene to Lower Pliocene age. With few exceptions, a northeastern palaeo-flow can be observed down to about 1050 m a.s.l. However, 100 m above this there appears to have been a late phase with an opposite palaeo-flow direction, and below this altitude this SW palaeo-flow direction prevails. These morphological observations allow us to propose a complex model. During low and moderate flow there is drainage to the north. During floods, a restriction in the north causes backwater and an overflow threshold to the SW is exceeded, and then most of the water flows in this direction. This observation of dual flow behaviour can help to better understand the behaviour of the karst water table and to interpret complex results from tracer experiments. The almost ubiquitous paragenetic features in the SBH are due to sediments derived from the local Upper Jurassic Radiolarite Group. For the evolution of karst plateaus in the Northern Calcareous Alps, these observations support a local and rather radial palaeo-drainage of the Totes Gebirge, as opposed to a through-flow of allogenic waters as is likely for other karst massifs.

As more information about the potential risks and complications related to breast implants has become available, the United States Food and Drug Administration (FDA) has responded by implementing changes to improve patient education, recalling certain devices and updating the recommendations for screening for silicone implant rupture. In addition to staying up-to-date with FDA actions and guidance, radiologists need to maintain awareness about the types of implants they may see, breast reconstruction techniques including the use of acellular dermal matrix, and the multimodality imaging of implants and their complications. Radiologists should also be familiar with some key differences between the updated FDA guidelines for implant screening and the imaging recommendations from the American College of Radiology Appropriateness Criteria. The addition of US as an acceptable screening exam for silicone implant rupture by the FDA is one of the most notable changes that has potentially significant implications.

Energy efficient implementations and deployments of Spiking neural networks (SNNs) have been of great interest due to the possibility of developing artificial systems that can achieve the computational powers and energy efficiency of the biological brain. Efficient implementations of SNNs on modern digital hardware are also inspired by advances in machine learning and deep neural networks (DNNs). Two techniques widely employed in the efficient deployment of DNNs -- the quantization and pruning of parameters, can both compress the model size, reduce memory footprints, and facilitate low-latency execution. The interaction between quantization and pruning and how they might impact model performance on SNN accelerators is currently unknown. We study various combinations of pruning and quantization in isolation, cumulatively, and simultaneously (jointly) to a state-of-the-art SNN targeting gesture recognition for dynamic vision sensor cameras (DVS). We show that this state-of-the-art model is amenable to aggressive parameter quantization, not suffering from any loss in accuracy down to ternary weights. However, pruning only maintains iso-accuracy up to 80% sparsity, which results in 45% more energy than the best quantization on our architectural model. Applying both pruning and quantization can result in an accuracy loss to offer a favourable trade-off on the energy-accuracy Pareto-frontier for the given hardware configuration., Comment: Code https://github.com/Intelligent-Microsystems-Lab/SNNQuantPrune

Using data on the registration of clinical trials and the disclosure of trial results, we examine how firms respond to peer disclosures. We find that firms are less likely to disclose their own trial results if the results of a larger number of closely related trials are disclosed by their peers. This relation is stronger if the firms face higher competition (as measured by the number of competing trials). It is weaker if the firms are further along in their research than the peers (as measured by the trials’ phase) and if the peers’ disclosures convey more negative news (as measured by the firms’ stock price reaction). We also find that firms are more likely to abandon ongoing trials if a larger number of peers disclose the results of closely related trials. Additional tests suggest that this real effects channel does not drive the impact on the firms’ disclosure decisions. Data Availability: Data are available from the public sources cited in the text. JEL Classifications: M4.

Abstract: Background: Children with Attention Deficit Hyperactivity Disorder (ADHD) often face problems in the engagement and adherence of health-promoting behaviors, such as physical activity and sports. Stimulant treatment is effective for managing core symptoms, but it remains unclear if this type of treatment also normalizes the engagement in health-promoting behavior. In this case-control study, we aim to compare physical activity and sports participation between children with ADHD and healthy peers. Motor skills and aerobic fitness are investigated as potential mediators of differences between groups. Methods: Children with ADHD were matched to healthy peers based on sex, age, and socioeconomic status. Participants ( N=120; age: 10.8±1.4) reported their physical activity and sports participation using a 7-day recall protocol. Their engagement in activities at moderate and vigorous intensity as well as participation in individual and team sports was derived from the protocol. Participants further completed the Movement Assessment Battery for Children-2 (MABC-2) and a submaximal test on a cycling ergometer (PWC170). Results: Children with ADHD showed lower vigorous physical activity and participation in individual sports than healthy peers. They also achieved lower scores on the MABC-2 and the PWC170. Based on path-analyses, low PWC170 partially mediated the ADHD-related fewer engagement in vigorous physical activity and individual sports. Conclusion: Children with ADHD undergoing stimulant treatment show less participation in vigorous physical activity and individual sports than healthy peers. Poor aerobic fitness partly contributes to the relation between ADHD and low physical activity.

Intellectual curiosity - the tendency to seek out and engage in opportunities for effortful cognitive activity - is a crucial construct in educational research and beyond. Measures of intellectual curiosity vary widely in psychometric quality, and few measures have demonstrated validity and comparability of scores across multiple languages. We analyzed a novel, six-item intellectual curiosity scale (ICS) originally developed for cross-national comparisons in the context of the OECD's Programme for the International Assessment of Adult Competencies (PIAAC). Samples from six countries representing six national languages (U.S. Germany, France, Spain, Poland, and Japan; total N = 5,557) confirmed that the ICS possesses very good psychometric properties. The scale is essentially unidimensional and showed excellent reliability estimates. On top of factorial validity, the scale demonstrated strict measurement invariance across demographic segments (gender, age groups, and educational strata) and at least partial scalar invariance across countries. As per its convergent and divergent associations with a broad range of constructs (e.g., Open-Mindedness and other Big Five traits, Perseverance, Sensation Seeking, Job Orientations, and Vocational Interests), it also showed convincing construct validity. Given its internal and external relationships, we recommend the ICS for assessing intellectual curiosity, especially in cross-cultural research applications, yet we also point out future research areas.

The redox reactions of various lanthanide metals with 3-(4-pyridyl)pyrazole (4-PyPzH) or 3-(3-pyridyl)pyrazole (3-PyPzH) ligands yield the 2D network ∞2[Eu(4-PyPz)2(Py)2] containing divalent europium, the 3D frameworks ∞3[Ln(4-PyPz)3] and ∞3[Ln(3-PyPz)3] for trivalent cerium, praseodymium, neodymium, holmium, erbium, and thulium as well as ∞3[La(4-PyPz)3], and the 2D networks ∞2[Ln(4-PyPz)3(Py)] for trivalent cerium and thulium and ∞2[Ln2(4-PyPz)6]·Py for trivalent ytterbium and lutetium. The 18 lanthanide coordination polymers were synthesized under solvothermal conditions in pyridine (Py), partly acting as a co-ligand for some networks. The compounds exhibit a variety of luminescence properties, including metal-centered 4f–4f/5d–4f emission in the visible and near-infrared spectral range, metal-to-ligand energy transfer, and ligand-centered fluorescence and phosphorescence. The anionic ligands 3-PyPz− and 4-PyPz− serve as suitable antennas for lanthanide-based luminescence in the visible and near-infrared range through effective sensitization followed by emission through intra–4f transitions of the trivalent thulium, holmium, praseodymium, erbium, and neodymium. ∞2[Ce(4-PyPz)3(Py)], ∞3[Ce(4-PyPz)3], and ∞3[Ce(3-PyPz)3] exhibit strong degrees of reduction in the 5d excited states that differ in intensity compared to the ligand-based emission, resulting in a distinct emission ranging from pink to orange. The direct current magnetic studies show magnetic isolation of the lanthanide centers in the crystal lattice of ∞3[Ln(3-PyPz)3], Ln = Dy, Ho, and Er.

Zusammenfassung Die Debatten über Künstliche Intelligenz (KI) scheinen zum medialen Alltag zu gehören. Neue und komplexe Technik prägt offensichtlich die Gesellschaft und viele Menschen sind sich unsicher, was noch kommen wird. Die Zukunft ist aber kein Schicksal, sondern bildet als Konzept vielmehr eine Projektionsfläche, auf der verschiedene Menschen verschiedene Dinge sehen können. Der Artikel will daher ein paar bekannte Grundgedanken rekonstruieren und dazu eine pädagogische Reflexion anbieten. Tiere und Roboter lernen wahrscheinlich ähnlich wie der Mensch. Auch wenn Tiere und Roboter wahrscheinlich ähnlich wie der Menschen lernen, sind Menschen mehr als nur lernenden Wesen. Sie sind mimetische Nachahmer und erleben darin sowohl Anerkennung als auch Enttäuschung; zwei Dinge, welche sich wohl nur bedingt maschinell algorithmisieren lassen.

Objectives Standardized measures for assessing neurological patients needing palliative care remain scarce. The Integrated Palliative care Outcome Scale for neurological patients in its short form (IPOS Neuro-S8) helps assess and identify patients’ symptom burden and needs early but has not yet been validated in German. The aim was to culturally adapt and translate the IPOS Neuro-S8 into the German health-care context and evaluate its face and content validity. Methods Cultural adaptation study following the first 6 out of 8 phases of the Palliative care Outcome Scale measures manual: (1) conceptual definition, (2) forward translation to German, (3) backward translation to English, (4) expert review, (5) cognitive debriefing, (6) proofreading. Neurological patients needing palliative care and clinical staff of the Department of Palliative Medicine or Neurology of the University Hospital of Cologne were included. Data were analyzed using thematic content analysis and descriptive statistics. Results A total of 13 patients and 16 clinical staff participated in this study. The expert review panel (phase 4) consisted of 11 additional members. While patients (n = 9) and clinical staff (n = 11) confirmed that the IPOS Neuro-S8 is an intelligible tool that is well accepted (phase 5), some linguistic and cultural differences were found between the original English and German versions. These mainly concerned the items mouth problems and spasms. Significance of results The German version of the IPOS Neuro-S8 has demonstrated face and content validity and captures relevant symptoms of neurological patients needing palliative care. Its psychometric properties, including construct and criterion validity, will be investigated next.

ContextThere is a global Human Papillomavirus (HPV) vaccine shortage until 2024. The World Health Organization recommended a temporary suspension of HPV vaccination for boys until all girls who need the vaccine can get it. In the European Union (EU), practices to define and monitor HPV vaccine shortages differ between the Member States. Prior policy initiatives were insufficient to address current vaccine shortages.Policy optionsDifferent policy options are recommended, divided into three self-developed clusters: prevention, response, and supply side. The policy options for the prevention part include decentralised surveillance and centralised surveillance. The policy options for the response part include dose sparing, EU joint procurement, postponing injection for young children, postponing vaccination for boys, and prioritisation in favour of low- and middle-income countries. The policy option for the supply side part is novel procurement agreements.RecommendationsA traffic light system to assist policymakers has been developed. The traffic light system recommends when policymakers should implement the suggested policy options. The traffic light system describes four stages: Green light (shortage prevention); Amber light (imminent shortage prevention); Red light (shortage management); Shortage lessons. These recommendations will improve EU crisis management.