The voices of Ukrainian and Russian scientists.

The brutal attack on Ukraine by the Russian Federation has shocked the world. While the world works to end the violence and help refugees, as a scientific journal, our thoughts are also with those in the scientific community who are directly or indirectly impacted by the war. We have been inspired by and applaud the labs around the world that have opened their doors to displaced scientists and remain committed to supporting scientists, whoever and wherever they are. Because science requires collaboration and trust, we urge the scientific community to continue efforts like this and to remain united, especially in times as difficult as these. In this Voices piece, we feature short comments from scientists from Ukraine and scientists from Russia. This small sampling is far from exhaustive, but our sincere thanks go to those scientists who were willing to share their thoughts on this volatile and emotionally charged situation; the views expressed are those of the contributors alone. We join the world in hoping for a swift resolution to the conflict, for the good of humanity.

East-to-west human dispersal into Europe 1.4 million years ago.

Stone tools stratified in alluvium and loess at Korolevo, western Ukraine, have been studied by several research groups1-3 since the discovery of the site in the 1970s. Although Korolevo's importance to the European Palaeolithic is widely acknowledged, age constraints on the lowermost lithic artefacts have yet to be determined conclusively. Here, using two methods of burial dating with cosmogenic nuclides4,5, we report ages of 1.42 ± 0.10 million years and 1.42 ± 0.28 million years for the sedimentary unit that contains Mode-1-type lithic artefacts. Korolevo represents, to our knowledge, the earliest securely dated hominin presence in Europe, and bridges the spatial and temporal gap between the Caucasus (around 1.85-1.78 million years ago)6 and southwestern Europe (around 1.2-1.1 million years ago)7,8. Our findings advance the hypothesis that Europe was colonized from the east, and our analysis of habitat suitability9 suggests that early hominins exploited warm interglacial periods to disperse into higher latitudes and relatively continental sites-such as Korolevo-well before the Middle Pleistocene Transition.

Europeans' support for refugees of varying background is stable over time.

Protracted global conflicts during the past decade have led to repeated major humanitarian protection crises in Europe. During the height of the Syrian refugee crisis at the end of 2015, Europe hosted around 2.3 million people requesting asylum1. Today, the ongoing war in Ukraine has resulted in one of the largest humanitarian emergencies in Europe since World War II, with more than eight million Ukrainians seeking refuge across Europe2. Here we explore whether repeated humanitarian crises threaten to exhaust solidarity and whether Europeans welcome Ukrainian asylum seekers over other asylum seekers3,4. We conducted repeat conjoint experiments during the 2015-2016 and 2022 refugee crises, asking 33,000 citizens in 15 European countries to evaluate randomly varied profiles of asylum seekers. We find that public preferences for asylum seekers with specific attributes have remained remarkably stable and general support has, if anything, increased slightly over time. Ukrainian asylum seekers were welcomed in 2022, with their demographic, religious and displacement profile having a larger role than their nationality. Yet, this welcome did not come at the expense of support for other marginalized refugee groups, such as Muslim refugees. These findings have implications for our theoretical understanding of the drivers and resilience of public attitudes towards refugees and for policymakers tasked to find effective responses to the enduring stress on the asylum system5-8.

Peer conformity and competition shape how business managers evaluate withdrawals from Russia amid the Ukraine War.

States have long used economic sanctions in response to violations of international law as a strategy to restore order. Increasingly, firms also reject doing business with violators. In response to the war in Ukraine, hundreds of multinational corporations voluntarily withdrew from Russia, even when policymakers were still debating the extent of sanctions. How did firm managers evaluate whether to withdraw from the Russian market? Using a survey experiment with Japanese firm managers conducted three months after the Russian invasion of Ukraine in 2022, we explore how peer effects-information on what other firms are doing in response to the crisis-influence support for withdrawal of business activity with Russia. Our findings show that information about withdrawal by other firms from a diverse set of countries promotes peer conformity that increases support. In contrast, information about ongoing business with Russia by Chinese firms fosters competition that reduces support. Market exposure moderates these reactions, although the concern about peer behavior does not appear to be driven by a reputation mechanism. Our research provides insight into how business actors perceive the strategic interplay of peer influence and market dynamics in the context of geopolitical conflicts.

Public response to government alerts saves lives during Russian invasion of Ukraine.

War is the cause of tremendous human suffering. To reduce such harm, governments have developed tools to alert civilians of imminent threats. Whether these systems are effective remains largely unknown. We study the introduction of an innovative smartphone application that notifies civilians of impending military operations developed in coordination with the Ukrainian government after the Russian invasion. We leverage quasi-experimental variation in the timing of more than 3,000 alerts to study civilian sheltering behavior, using high-frequency geolocation pings tied to 17 million mobile devices, 60% of the connected population in Ukraine. We find that, overall, civilians respond sharply to alerts, quickly seeking shelter. These rapid postalert changes in population movement attenuate over time, however, in a manner that cannot be explained by adaptive sheltering behavior or calibration to the signal quality of alerts. Responsiveness is weakest when civilians have been living under an extended state of emergency, consistent with the presence of an alert fatigue effect. Our results suggest that 35 to 45% of observed civilian casualties were avoided because of public responsiveness to the messaging system. Importantly, an additional 8 to 15% of civilian casualties observed during the later periods of the conflict could have been avoided with sustained public responsiveness to government alerts. We provide evidence that increasing civilians' risk salience through targeted government messaging can increase responsiveness, suggesting a potential policy lever for sustaining public engagement during prolonged episodes of conflict.

Estimating conflict losses and reporting biases.

Determining the number of casualties and fatalities suffered in militarized conflicts is important for conflict measurement, forecasting, and accountability. However, given the nature of conflict, reliable statistics on casualties are rare. Countries or political actors involved in conflicts have incentives to hide or manipulate these numbers, while third parties might not have access to reliable information. For example, in the ongoing militarized conflict between Russia and Ukraine, estimates of the magnitude of losses vary wildly, sometimes across orders of magnitude. In this paper, we offer an approach for measuring casualties and fatalities given multiple reporting sources and, at the same time, accounting for the biases of those sources. We construct a dataset of 4,609 reports of military and civilian losses by both sides. We then develop a statistical model to better estimate losses for both sides given these reports. Our model accounts for different kinds of reporting biases, structural correlations between loss types, and integrates loss reports at different temporal scales. Our daily and cumulative estimates provide evidence that Russia has lost more personnel than has Ukraine and also likely suffers from a higher fatality to casualty ratio. We find that both sides likely overestimate the personnel losses suffered by their opponent and that Russian sources underestimate their own losses of personnel.

Transcultural pathways to the will to fight.

In 2022, the "Will to Fight Act" was referred to the US Congress urging attention to measuring and assessing will to fight. That Bill was not enacted, and evaluation efforts within the political and military establishment remain contentious, fragmented, and meager. This likely will persist, along with attendant policy failures and grievous costs, without awareness of research that the social and psychological sciences reveal on the will to fight [S. Atran, Science 373, 1063 (2021)]. We illustrate such research using converging data from a multimethod and multicultural approach, including field and online studies from the Middle East, North Africa, and Europe. These studies reveal specific psychosocial pathways, within a general causal framework, that predict willingness to make costly sacrifices, including to cooperate, fight, and die in war and sustained conflict. From the continuing strife in Iraq to embattled Ukraine, 31 studies were conducted in 9 countries with nearly 12,000 participants. These include people in longstanding conflicts, refugees, imprisoned jihadists and gangs, US military, studies in Ukraine before and during the current war, and rolling studies with a European ally of Ukraine. Results provide evidence for a mediation model of transcultural pathways to the will to fight. Building on our previous behavioral and brain research, on the battlefield in Iraq, with violent extremists, and with US military, the linear mediation yielding the will to fight involves identity fusion, perceived spiritual formidability, and trust. The model, a variation on "The Devoted Actor Framework," applies to primary reference groups, core cultural values, and leaders.

Challenges for chemistry in Ukraine after the war: Ukrainian science requires rebuilding and support.

The unprovoked Russian invasion has created considerable challenges for Ukrainian science. In this article, we discuss actions needed to support and rebuild Ukrainian science and educational systems. The proposed actions take into account past Ukrainian scientific achievements including developments in organic chemistry.

Use of Open-Source Epidemic Intelligence for Infectious Disease Outbreaks, Ukraine, 2022.

Formal infectious disease surveillance in Ukraine has been disrupted by Russia's 2022 invasion, leading to challenges with tracking and containing epidemics. To analyze the effects of the war on infectious disease epidemiology, we used open-source data from EPIWATCH, an artificial intelligence early-warning system. We analyzed patterns of infectious diseases and syndromes before (November 1, 2021-February 23, 2022) and during (February 24-July 31, 2022) the conflict. We compared case numbers for the most frequently reported diseases with numbers from formal sources and found increases in overall infectious disease reports and in case numbers of cholera, botulism, tuberculosis, HIV/AIDS, rabies, and salmonellosis during compared with before the invasion. During the conflict, although open-source intelligence captured case numbers for epidemics, such data (except for diphtheria) were unavailable/underestimated by formal surveillance. In the absence of formal surveillance during military conflicts, open-source data provide epidemic intelligence useful for infectious disease control.

Drug-Resistant Tuberculosis, Georgia, Kazakhstan, Kyrgyzstan, Moldova, and Ukraine, 2017-2022.

In 2021, the World Health Organization recommended new extensively drug-resistant (XDR) and pre-XDR tuberculosis (TB) definitions. In a recent cohort of TB patients in Eastern Europe, we show that XDR TB as currently defined is associated with exceptionally poor treatment outcomes, considerably worse than for the former definition (31% vs. 54% treatment success).

Outcome of malignant lymphoma in Ukraine. Analysis of 563 cases registered in the Ukrainian Lymphoma Registry in 2019-2021.

We report the outcome of 563 cases of newly diagnosed lymphoma registered in 2019-2021, including 176 cases (31.2%) of Hodgkin lymphoma (HL), 130 (23.1%) of diffuse large B-cell lymphoma (DLBCL), 28 (5%) of follicular lymphoma (FL), 16 (2.9%) of mantle cell lymphoma (MCL) and 20 (3.5%) of peripheral T-cell lymphoma (PTCL). After a median follow-up of 30.1 months (95% CI: 28.8-31.3), the 3-year overall survival rates were 95%, 83%, 86%, 100%, 61% and 42% for HL, DLBCL, CLL, FL, MCL and PTCL respectively. These data offer valuable information on the curability of lymphoma patients in Ukraine, in a real-world setting.

Status of HIV and comorbidities in refugees with HIV from Ukraine.

PURPOSE: To describe the clinical characteristics of refugees with HIV from Ukraine that seek continuation of medical care in Germany. METHODS: Fourty-six refugees with HIV that had left Ukraine between 24 February and 30 December 2022 were examined. Information on patients' history was obtained using a standardized questionnaire for clinical care. Interviews were conducted in Russian during their first clinical presentation. RESULTS: Fourty-six persons (41 females and 5 males) were included and their mean age was 39.6 (±8.4) years. The mean time since HIV diagnosis was 8.0 (median, IQR 7.15) years and 70.3% of participants currently received tenfofovir-DF, lamividine and dolutegravir. Most refugees had an undetectable HIV viral load and their current mean CD4 T cell count was 702 (SD ± 289) per µL. Serology revealed previous hepatitis B infection in 50.4% without evidence for replication, with undetectable anti-hepatitis B surface antigen in the remaining refugees. Antibodies against hepatitis C were present in 23 refugees (50%), but only 10 patients had been diagnosed with hepatitis C previously. Five refugees had undergone successful antiviral treatment for hepatitis C. Detectable HCV-RNA was evident in nine patients (19.6%). Sixteen (38.6%) refugees had a positive tuberculosis (TB) interferon gamma release assay, and four were on TB treatment for previously diagnosed infection. One had been diagnosed with multidrug-resistant (MDR) TB, two with pre-extensively drug-resistant (pre-XDR) TB and two with XDR TB and were treated with combinations of second-line and novel agents according to WHO guidelines. CONCLUSIONS: Based on this preliminary analysis of a not fully representative cohort, refugees with HIV from Ukraine were young, mostly healthy females highly adherent to antiretroviral therapy. The rate of transmittable co-infections urges early diagnostic evaluation and treatment.

The burden of infectious diseases throughout and after the COVID-19 pandemic (2020-2023) and Russo-Ukrainian war migration.

Understanding how the infectious disease burden was affected throughout the COVID-19 pandemic is pivotal to identifying potential hot spots and guiding future mitigation measures. Therefore, our study aimed to analyze the changes in the rate of new cases of Poland's most frequent infectious diseases during the entire COVID-19 pandemic and after the influx of war refugees from Ukraine. We performed a registry-based population-wide study in Poland to analyze the changes in the rate of 24 infectious disease cases from 2020 to 2023 and compared them to the prepandemic period (2016-2019). Data were collected from publicly archived datasets of the Epimeld database published by national epidemiological authority institutions. The rate of most of the studied diseases (66.6%) revealed significantly negative correlations with the rate of SARS-CoV-2 infections. For the majority of infectious diseases, it substantially decreased in 2020 (in case of 83%) and 2021 (63%), following which it mostly rebounded to the prepandemic levels and, in some cases, exceeded them in 2023 when the exceptionally high annual rates of new cases of scarlet fever, Streptococcus pneumoniae infections, HIV infections, syphilis, gonococcal infections, and tick-borne encephalitis were noted. The rate of Clostridioides difficile enterocolitis was two-fold higher than before the pandemic from 2021 onward. The rate of Legionnaires' disease in 2023 also exceeded the prepandemic threshold, although this was due to a local outbreak unrelated to lifted COVID-19 pandemic restrictions or migration of war refugees. The influx of war migrants from Ukraine could impact the epidemiology of sexually transmitted diseases. The present analysis indicates that continued efforts are needed to prevent COVID-19 from overwhelming healthcare systems again and decreasing the control over the burden of other infectious diseases. It also identifies the potential tipping points that require additional mitigation measures, which are also discussed in the paper, to avoid escalation in the future.

Sleep Duration, Insomnia, and Associated Factors Among Ukrainians 1 Year After Russia's Full-Scale Invasion.

OBJECTIVE: We aimed to investigate the prevalence of sleep disturbances and associated factors among Ukrainians 1 year after Russia's full-scale invasion. METHODS: Quota sampling was used to collect online survey data from 2364 adults living in Ukraine aged 18 to 79 years from April 5, 2023, to May 15, 2023. Short sleep duration was defined as sleep duration ≤6 hours and long sleep duration as ≥9 hours. Insomnia was assessed by the Insomnia Symptom Questionnaire. RESULTS: The prevalences of short sleep duration, long sleep duration, and insomnia were 39.4%, 6.9%, and 38.5%, respectively. Short sleep duration and insomnia were both more likely in females (short sleep duration: adjusted odds ratio [aOR] = 1.44; insomnia: aOR = 2.17), individuals with depression (short sleep duration: aOR = 1.61; insomnia: aOR = 7.76), affected by the 2014 Russian invasion (short sleep duration: aOR = 1.37; insomnia: aOR = 1.78), and with more trauma events (short sleep duration: quartile 3 [Q3] versus Q1: aOR = 1.88; Q4 versus Q1: aOR = 1.83; insomnia: Q3 versus Q1: aOR = 2.14; Q4 versus Q1: aOR = 2.32). Insomnia was more likely in Ukrainians with posttraumatic stress disorder (aOR = 2.95), anxiety (aOR = 4.57), and loneliness (aOR = 1.67). Essential public service was associated with short sleep duration (aOR = 1.64). Short sleep duration and insomnia were associated with lower quality of life in physical, psychological, and environmental domains. Insomnia was associated with the social relationships domain. CONCLUSIONS: Sleep health among Ukrainian adults 1 year into the war is concerning, with more than one-third reporting inadequate sleep or insomnia. More studies are needed on impacts and interventions for sleep health during and after the war.

Radiation hazards of the Ukraine nuclear power plants: how can international blood and marrow stem cell transplant societies help?

Any conflict in countries that process nuclear power plants raises concerns of the potential radiation injuries to the people in that region and beyond such as the current conflict in Ukraine. International healthcare organizations and societies should prepare for the potential scenarios of nuclear incidents. The Worldwide Network for Blood and Marrow Transplantation (WBMT) and its members, have recent experience preparing for this type of events such as the Fukushima incident in 2011. In this article, we discuss the risks of radiation exposure, current guidelines, and scientific evidence on hematopoietic support, including the role of hematopoietic stem cell transplant (HCT) for those exposed to nuclear radiation, and the role that the WBMT and other global BMT societies can play in triaging and managing people suffering from radiation injuries.

The international of wisdom.

Russia's invasion of Ukraine is the continuation of Soviet communism's aggressive expansion. But as under communism, freedom of thought will prevail.

Rubble to Rouble: how can science respond to war?

The unprovoked war on Ukraine has left many in the global scientific community, including Russia, shellshocked. We need to persuade the Kremlin to return to a rules-based international order, while supporting Ukrainians, but also Russian scientists facing both internal and external sanctions.

Concerns about academic freedom caused by the Russia-Ukraine War.

Russia's war against Ukraine has raised concerns not about the fate of Ukrainian science and scientists but also academic freedom and international cooperation in science.