Germany in the Russian-Ukrainian conflict: a political or a humanitarian mission? OSW Commentary No. 163, 2015-02-18

Since the beginning of the Russian-Ukrainian conflict, profound changes in Germany’s thinking about Russia, its political elite and foreign policy, can be observed. The trust most German politicians had in their former strategic partner has now lessened. At the same time, Germany has been particularly involved in the process of resolving the conflict, which was demonstrated by the intensive diplomatic actions it undertook. When these failed, Chancellor Angela Merkel did not hesitate to force through the introduction and maintenance of economic sanctions. At the same time, however, this evolution in Germany’s thinking about Russia has not translated into any change in the two basic assumptions of the German attitude towards a possible solution to the conflict. First, Germany supports the concept of ‘strategic patience’ in politics in the context of Russia’s aggression. Second, it is convinced that Europe is fated to cooperate with the Russian Federation, and Europe’s welfare and security are only possible with Russia as a partner in cooperation, not against it or without it. Therefore, in the immediate future no radical change in Germany’s policy as pursued so far should be expected. This provokes questions concerning not only the effectiveness of Berlin’s current actions, but also – in a broader sense – Germany’s ability to negotiate and achieve real, political solutions to the Russian-Ukrainian conflict, reaching beyond (another) ceasefire. The Minsk agreements of 12 February can be considered a success worthy of a humanitarian mission carried out in the hope of reducing the number of casualties. However, the political mission undertaken by Chancellor Merkel and Foreign Minister Steinmeier aimed at “ensuring Europe’s security order”[1] has so far resulted in the sense of helplessness and frustration which have recently dominated Germany’s policy towards Russia[2].

The Special Monitoring Mission in Ukraine: a useful but flawed OSCE tool. EPC Policy Brief, 23 April 2015

The OSCE’s Special Monitoring Mission in Ukraine functions as the eyes and ears of the international community in Eastern Ukraine; it monitors, impartially, the ongoing conflict between Ukraine and Russia and observes whether or not both parties comply with the Minsk II Agreement. The success, or failure, of this Mission will not only be of crucial importance for the situation in Eastern Ukraine, but will also determine the OSCE’s entire future and ability to operate in conflict regions. Although the SMM is a flawed tool, Dennis Sammut and Joseph D’Urso argue that its deployment and the subsequent reinvigoration of OSCE is the perfect opportunity for the EU to rethink its relation to and position in the organisation, and to assume a bigger and more decisive role.

EU Mission in Kosovo (EULEX): Constructing Ambiguity or Constructive Disunity? Transatlantic Security Paper No. 3, June 2011

In which skies should auspices about the future of EU foreign policy be looked for, Libya’s or Kosovo’s? Many commentators have been prompt in digging the grave for EU Security and Defense Policy after Member States’ discordance over taking military action against the Qaddafi regime1. However, as this paper will emphasize through the case of Kosovo, unanimity is not always an indispensable prerequisite – and should not be regarded as the sole criteria – to EU action in regional security. Overly focusing on the ‘speak with one voice’ mantra sometimes leads to stop short of assessing actual outcomes.

Clinical prediction of large vessel occlusion in anterior circulation stroke: mission impossible?

Simple clinical scores to predict large vessel occlusion (LVO) in acute ischemic stroke would be helpful to triage patients in the prehospital phase. We assessed the ability of various combinations of National Institutes of Health Stroke Scale (NIHSS) subitems and published stroke scales (i.e., RACE scale, 3I-SS, sNIHSS-8, sNIHSS-5, sNIHSS-1, mNIHSS, a-NIHSS items profiles A-E, CPSS1, CPSS2, and CPSSS) to predict LVO on CT or MR arteriography in 1085 consecutive patients (39.4 % women, mean age 67.7 years) with anterior circulation strokes within 6 h of symptom onset. 657 patients (61 %) had an occlusion of the internal carotid artery or the M1/M2 segment of the middle cerebral artery. Best cut-off value of the total NIHSS score to predict LVO was 7 (PPV 84.2 %, sensitivity 81.0 %, specificity 76.6 %, NPV 72.4 %, ACC 79.3 %). Receiver operating characteristic curves of various combinations of NIHSS subitems and published scores were equally or less predictive to show LVO than the total NIHSS score. At intersection of sensitivity and specificity curves in all scores, at least 1/5 of patients with LVO were missed. Best odds ratios for LVO among NIHSS subitems were best gaze (9.6, 95 %-CI 6.765-13.632), visual fields (7.0, 95 %-CI 3.981-12.370), motor arms (7.6, 95 %-CI 5.589-10.204), and aphasia/neglect (7.1, 95 %-CI 5.352-9.492). There is a significant correlation between clinical scores based on the NIHSS score and LVO on arteriography. However, if clinically relevant thresholds are applied to the scores, a sizable number of LVOs are missed. Therefore, clinical scores cannot replace vessel imaging.