Browsing by Subject "Europe"
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Item Open Access Assault rifles; definitions, evolutionary history and medical consequences.(Journal of the Mississippi State Medical Association, 1990-12) Severance, HWIn summary, the evolutionary history of assault rifles may be of interest to some medical practitioners. It is important to realize that the term "assault rifle" is incorrectly and overused in the lay press. As a rough generalization, the wounds from such weapons may fall in between those of handguns on one side and full-sized rifles on the other. The major caveat is that there can be major variations in the severity of any wound by any weapon and though it may be of some help in analyzing potential damage, knowledge of the inflicting weapon does not replace the need for good, well established principles of wound management.Item Open Access Characteristics of deformity surgery in patients with severe and rigid cervical kyphosis (CK): results of the CSRS-Europe multi-centre study project.(European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2019-02) Koller, H; Ames, C; Mehdian, H; Bartels, R; Ferch, R; Deriven, V; Toyone, H; Shaffrey, C; Smith, J; Hitzl, W; Schröder, J; Robinson, YohanIntroduction and purpose
Little information exists on surgical characteristics, complications and outcomes with corrective surgery for rigid cervical kyphosis (CK). To collate the experience of international experts, the CSRS-Europe initiated an international multi-centre retrospective study.Methods
Included were patients at all ages with rigid CK. Surgical and patient specific characteristics, complications and outcomes were studied. Radiographic assessment included global and regional sagittal parameters. Cervical sagittal balance was stratified according to the CSRS-Europe classification of sagittal cervical balance (types A-D).Results
Eighty-eight patients with average age of 58 years were included. CK etiology was ankylosing spondlitis (n = 34), iatrogenic (n = 25), degenerative (n = 9), syndromatic (n = 6), neuromuscular (n = 4), traumatic (n = 5), and RA (n = 5). Blood loss averaged 957 ml and the osteotomy grade 4.CK-correction and blood loss increased with osteotomy grade (r = 0.4/0.6, p < .01). Patients with different preop sagittal balance types had different approaches, preop deformity parameters and postop alignment changes (e.g. C7-slope, C2-7 SVA, translation). Correction of the regional kyphosis angle (RKA) was average 34° (p < .01). CK-correction was increased in patients with osteoporosis and osteoporotic vertebrae (POV, p = .006). 22% of patients experienced a major long-term complication and 14% needed revision surgery. Patients with complications had larger preop RKA (p = .01), RKA-change (p = .005), and postop increase in distal junctional kyphosis angle (p = .02). The POV-Group more often experienced postop complications (p < .0001) and revision surgery (p = .02). Patients with revision surgery had a larger RKA-change (p = .003) and postop translation (p = .04). 21% of patients had a postop segmental motor deficit and the risk was elevated in the POV-Group (p = .001).Conclusions
Preop patient specific, radiographic and surgical variables had a significant bearing on alignment changes, outcomes and complication occurrence in the treatment of rigid CK.Item Open Access Comprehensive Evaluation of European Renewable Power Programs(2016-04-26) Buczek, Kate; Han, Siqi; Umarje, TanviEurope has shown a commitment to goal setting that mitigates climate change and increases renewable energy generation since the early 2000s. Germany, Spain, and the United Kingdom have experienced challenges throughout the process toward a renewable energy future. The level that market structure, policy impacts, country economics, technology status, and social impacts contribute to successful renewable energy integration with the traditional power market structure for Germany, Spain, and the UK will provide an evaluation framework for other countries looking to incorporate greater levels of renewable energy in the grid. Primary lessons learned from the electricity systems in these three countries show that flawed policy design creates market uncertainty and instability, subsidies may create more generation at increased costs, grid flexibility is necessary to integrate higher capacities of renewable energy resources, business models in the electricity sector should be transformed by changing trends to account for reduced conventional energy and focus on innovation, and market mechanism design needs to capture wholesale energy prices to meet capacity.Item Open Access Design, recruitment, logistics, and data management of the GEHA (Genetics of Healthy Ageing) project.(Exp Gerontol, 2011-11) Skytthe, A; Valensin, S; Jeune, B; Cevenini, E; Balard, F; Beekman, M; Bezrukov, V; Blanche, H; Bolund, L; Broczek, K; Carru, C; Christensen, K; Christiansen, L; Collerton, JC; Cotichini, R; de Craen, AJM; Dato, S; Davies, K; De Benedictis, G; Deiana, L; Flachsbart, F; Gampe, J; Gilbault, C; Gonos, ES; Haimes, E; Hervonen, A; Hurme, MA; Janiszewska, D; Jylhä, M; Kirkwood, TBL; Kristensen, P; Laiho, P; Leon, A; Marchisio, A; Masciulli, R; Nebel, A; Passarino, G; Pelicci, G; Peltonen, L; Perola, M; Poulain, M; Rea, IM; Remacle, J; Robine, JM; Schreiber, S; Scurti, M; Sevini, F; Sikora, E; Skouteri, A; Slagboom, PE; Spazzafumo, L; Stazi, MA; Toccaceli, V; Toussaint, O; Törnwall, O; Vaupel, JW; Voutetakis, K; Franceschi, C; GEHA consortiumIn 2004, the integrated European project GEHA (Genetics of Healthy Ageing) was initiated with the aim of identifying genes involved in healthy ageing and longevity. The first step in the project was the recruitment of more than 2500 pairs of siblings aged 90 years or more together with one younger control person from 15 areas in 11 European countries through a coordinated and standardised effort. A biological sample, preferably a blood sample, was collected from each participant, and basic physical and cognitive measures were obtained together with information about health, life style, and family composition. From 2004 to 2008 a total of 2535 families comprising 5319 nonagenarian siblings were identified and included in the project. In addition, 2548 younger control persons aged 50-75 years were recruited. A total of 2249 complete trios with blood samples from at least two old siblings and the younger control were formed and are available for genetic analyses (e.g. linkage studies and genome-wide association studies). Mortality follow-up improves the possibility of identifying families with the most extreme longevity phenotypes. With a mean follow-up time of 3.7 years the number of families with all participating siblings aged 95 years or more has increased by a factor of 5 to 750 families compared to when interviews were conducted. Thus, the GEHA project represents a unique source in the search for genes related to healthy ageing and longevity.Item Open Access Ecological restoration of rich fens in Europe and North America: from trial and error to an evidence-based approach.(Biol Rev Camb Philos Soc, 2015-02) Lamers, Leon PM; Vile, Melanie A; Grootjans, Ab P; Acreman, Mike C; van Diggelen, Rudy; Evans, Martin G; Richardson, Curtis J; Rochefort, Line; Kooijman, Annemieke M; Roelofs, Jan GM; Smolders, Alfons JPFens represent a large array of ecosystem services, including the highest biodiversity found among wetlands, hydrological services, water purification and carbon sequestration. Land-use change and drainage has severely damaged or annihilated these services in many parts of North America and Europe; restoration plans are urgently needed at the landscape level. We review the major constraints on the restoration of rich fens and fen water bodies in agricultural areas in Europe and disturbed landscapes in North America: (i) habitat quality problems: drought, eutrophication, acidification, and toxicity, and (ii) recolonization problems: species pools, ecosystem fragmentation and connectivity, genetic variability, and invasive species; and here provide possible solutions. We discuss both positive and negative consequences of restoration measures, and their causes. The restoration of wetland ecosystem functioning and services has, for a long time, been based on a trial-and-error approach. By presenting research and practice on the restoration of rich fen ecosystems within agricultural areas, we demonstrate the importance of biogeochemical and ecological knowledge at different spatial scales for the management and restoration of biodiversity, water quality, carbon sequestration and other ecosystem services, especially in a changing climate. We define target processes that enable scientists, nature managers, water managers and policy makers to choose between different measures and to predict restoration prospects for different types of deteriorated fens and their starting conditions.Item Open Access European Market Evaluation for Long-Duration Energy Storage(2021-04-29) Guebert, Davis; Davis, KathrynLong-duration energy storage (LoDES) technologies and their global use cases are quickly advancing, with non-lithium-ion technology solutions being optimized for long-duration grid applications (>24hrs of continuous energy on a single charge). These technologies can serve as bi-directional power plants located in almost any market and scaled to match energy infrastructure globally. We focused our research on European energy markets and how LoDES companies can best position themselves against competitors. Our market assessment evaluates the current energy landscape, including policies, generation mix, stakeholders, and the market's lucrative potential, such as revenue staking, wholesale prices, and competitor criteria. We identified six potential European energy storage markets from which we classified a three-country subset to develop go-to-market strategies, detailing funding opportunities and potential partnerships. This analysis aims to give LoDES companies tangible direction to pursue European market entry.Item Open Access Family-directed umbilical cord blood banking.(Haematologica, 2011-11) Gluckman, Eliane; Ruggeri, Annalisa; Rocha, Vanderson; Baudoux, Etienne; Boo, Michael; Kurtzberg, Joanne; Welte, Kathy; Navarrete, Cristina; van Walraven, Suzanna M; Eurocord, Netcord, World Marrow Donor Association and National Marrow Donor ProgramUmbilical cord blood transplantation from HLA-identical siblings provides good results in children. These results support targeted efforts to bank family cord blood units that can be used for a sibling diagnosed with a disease which can be cured by allogeneic hematopoietic stem cell transplantation or for research that investigates the use of allogeneic or autologous cord blood cells. Over 500 patients transplanted with related cord blood units have been reported to the Eurocord registry with a 4-year overall survival of 91% for patients with non-malignant diseases and 56% for patients with malignant diseases. Main hematologic indications in children are leukemia, hemoglobinopathies or inherited hematologic, immunological or metabolic disorders. However, family-directed cord blood banking is not widely promoted; many cord blood units used in sibling transplantation have been obtained from private banks that do not meet the necessary criteria required to store these units. Marketing by private banks who predominantly store autologous cord blood units has created public confusion. There are very few current validated indications for autologous storage but some new indications might appear in the future. Little effort is devoted to provide unbiased information and to educate the public as to the distinction between the different types of banking, economic models and standards involved in such programs. In order to provide a better service for families in need, directed-family cord blood banking activities should be encouraged and closely monitored with common standards, and better information on current and future indications should be made available.Item Open Access Focal therapy in prostate cancer-report from a consensus panel.(J Endourol, 2010-05) de la Rosette, J; Ahmed, H; Barentsz, J; Johansen, T Bjerklund; Brausi, M; Emberton, M; Frauscher, F; Greene, D; Harisinghani, M; Haustermans, K; Heidenreich, A; Kovacs, G; Mason, M; Montironi, R; Mouraviev, V; de Reijke, T; Taneja, S; Thuroff, S; Tombal, B; Trachtenberg, J; Wijkstra, H; Polascik, TPURPOSE: To establish a consensus in relation to case selection, conduct of therapy, and outcomes that are associated with focal therapy for men with localized prostate cancer. MATERIAL AND METHODS: Urologic surgeons, radiation oncologists, radiologists, and histopathologists from North America and Europe participated in a consensus workshop on focal therapy for prostate cancer. The consensus process was face to face within a structured meeting, in which pertinent clinical issues were raised, discussed, and agreement sought. Where no agreement was possible, this was acknowledged, and the nature of the disagreement noted. RESULTS: Candidates for focal treatment should have unilateral low- to intermediate-risk disease with clinical stageItem Open Access Genetic diversity fuels gene discovery for tobacco and alcohol use.(Nature, 2022-12) Saunders, Gretchen RB; Wang, Xingyan; Chen, Fang; Jang, Seon-Kyeong; Liu, Mengzhen; Wang, Chen; Gao, Shuang; Jiang, Yu; Khunsriraksakul, Chachrit; Otto, Jacqueline M; Addison, Clifton; Akiyama, Masato; Albert, Christine M; Aliev, Fazil; Alonso, Alvaro; Arnett, Donna K; Ashley-Koch, Allison E; Ashrani, Aneel A; Barnes, Kathleen C; Barr, R Graham; Bartz, Traci M; Becker, Diane M; Bielak, Lawrence F; Benjamin, Emelia J; Bis, Joshua C; Bjornsdottir, Gyda; Blangero, John; Bleecker, Eugene R; Boardman, Jason D; Boerwinkle, Eric; Boomsma, Dorret I; Boorgula, Meher Preethi; Bowden, Donald W; Brody, Jennifer A; Cade, Brian E; Chasman, Daniel I; Chavan, Sameer; Chen, Yii-Der Ida; Chen, Zhengming; Cheng, Iona; Cho, Michael H; Choquet, Hélène; Cole, John W; Cornelis, Marilyn C; Cucca, Francesco; Curran, Joanne E; de Andrade, Mariza; Dick, Danielle M; Docherty, Anna R; Duggirala, Ravindranath; Eaton, Charles B; Ehringer, Marissa A; Esko, Tõnu; Faul, Jessica D; Fernandes Silva, Lilian; Fiorillo, Edoardo; Fornage, Myriam; Freedman, Barry I; Gabrielsen, Maiken E; Garrett, Melanie E; Gharib, Sina A; Gieger, Christian; Gillespie, Nathan; Glahn, David C; Gordon, Scott D; Gu, Charles C; Gu, Dongfeng; Gudbjartsson, Daniel F; Guo, Xiuqing; Haessler, Jeffrey; Hall, Michael E; Haller, Toomas; Harris, Kathleen Mullan; He, Jiang; Herd, Pamela; Hewitt, John K; Hickie, Ian; Hidalgo, Bertha; Hokanson, John E; Hopfer, Christian; Hottenga, JoukeJan; Hou, Lifang; Huang, Hongyan; Hung, Yi-Jen; Hunter, David J; Hveem, Kristian; Hwang, Shih-Jen; Hwu, Chii-Min; Iacono, William; Irvin, Marguerite R; Jee, Yon Ho; Johnson, Eric O; Joo, Yoonjung Y; Jorgenson, Eric; Justice, Anne E; Kamatani, Yoichiro; Kaplan, Robert C; Kaprio, Jaakko; Kardia, Sharon LR; Keller, Matthew C; Kelly, Tanika N; Kooperberg, Charles; Korhonen, Tellervo; Kraft, Peter; Krauter, Kenneth; Kuusisto, Johanna; Laakso, Markku; Lasky-Su, Jessica; Lee, Wen-Jane; Lee, James J; Levy, Daniel; Li, Liming; Li, Kevin; Li, Yuqing; Lin, Kuang; Lind, Penelope A; Liu, Chunyu; Lloyd-Jones, Donald M; Lutz, Sharon M; Ma, Jiantao; Mägi, Reedik; Manichaikul, Ani; Martin, Nicholas G; Mathur, Ravi; Matoba, Nana; McArdle, Patrick F; McGue, Matt; McQueen, Matthew B; Medland, Sarah E; Metspalu, Andres; Meyers, Deborah A; Millwood, Iona Y; Mitchell, Braxton D; Mohlke, Karen L; Moll, Matthew; Montasser, May E; Morrison, Alanna C; Mulas, Antonella; Nielsen, Jonas B; North, Kari E; Oelsner, Elizabeth C; Okada, Yukinori; Orrù, Valeria; Palmer, Nicholette D; Palviainen, Teemu; Pandit, Anita; Park, S Lani; Peters, Ulrike; Peters, Annette; Peyser, Patricia A; Polderman, Tinca JC; Rafaels, Nicholas; Redline, Susan; Reed, Robert M; Reiner, Alex P; Rice, John P; Rich, Stephen S; Richmond, Nicole E; Roan, Carol; Rotter, Jerome I; Rueschman, Michael N; Runarsdottir, Valgerdur; Saccone, Nancy L; Schwartz, David A; Shadyab, Aladdin H; Shi, Jingchunzi; Shringarpure, Suyash S; Sicinski, Kamil; Skogholt, Anne Heidi; Smith, Jennifer A; Smith, Nicholas L; Sotoodehnia, Nona; Stallings, Michael C; Stefansson, Hreinn; Stefansson, Kari; Stitzel, Jerry A; Sun, Xiao; Syed, Moin; Tal-Singer, Ruth; Taylor, Amy E; Taylor, Kent D; Telen, Marilyn J; Thai, Khanh K; Tiwari, Hemant; Turman, Constance; Tyrfingsson, Thorarinn; Wall, Tamara L; Walters, Robin G; Weir, David R; Weiss, Scott T; White, Wendy B; Whitfield, John B; Wiggins, Kerri L; Willemsen, Gonneke; Willer, Cristen J; Winsvold, Bendik S; Xu, Huichun; Yanek, Lisa R; Yin, Jie; Young, Kristin L; Young, Kendra A; Yu, Bing; Zhao, Wei; Zhou, Wei; Zöllner, Sebastian; Zuccolo, Luisa; 23andMe Research Team; Biobank Japan Project; Batini, Chiara; Bergen, Andrew W; Bierut, Laura J; David, Sean P; Gagliano Taliun, Sarah A; Hancock, Dana B; Jiang, Bibo; Munafò, Marcus R; Thorgeirsson, Thorgeir E; Liu, Dajiang J; Vrieze, ScottTobacco and alcohol use are heritable behaviours associated with 15% and 5.3% of worldwide deaths, respectively, due largely to broad increased risk for disease and injury1-4. These substances are used across the globe, yet genome-wide association studies have focused largely on individuals of European ancestries5. Here we leveraged global genetic diversity across 3.4 million individuals from four major clines of global ancestry (approximately 21% non-European) to power the discovery and fine-mapping of genomic loci associated with tobacco and alcohol use, to inform function of these loci via ancestry-aware transcriptome-wide association studies, and to evaluate the genetic architecture and predictive power of polygenic risk within and across populations. We found that increases in sample size and genetic diversity improved locus identification and fine-mapping resolution, and that a large majority of the 3,823 associated variants (from 2,143 loci) showed consistent effect sizes across ancestry dimensions. However, polygenic risk scores developed in one ancestry performed poorly in others, highlighting the continued need to increase sample sizes of diverse ancestries to realize any potential benefit of polygenic prediction.Item Open Access Genome-wide linkage analysis for human longevity: Genetics of Healthy Aging Study.(Aging Cell, 2013-04) Beekman, Marian; Blanché, Hélène; Perola, Markus; Hervonen, Anti; Bezrukov, Vladyslav; Sikora, Ewa; Flachsbart, Friederike; Christiansen, Lene; De Craen, Anton JM; Kirkwood, Tom BL; Rea, Irene Maeve; Poulain, Michel; Robine, Jean-Marie; Valensin, Silvana; Stazi, Maria Antonietta; Passarino, Giuseppe; Deiana, Luca; Gonos, Efstathios S; Paternoster, Lavinia; Sørensen, Thorkild IA; Tan, Qihua; Helmer, Quinta; van den Akker, Erik B; Deelen, Joris; Martella, Francesca; Cordell, Heather J; Ayers, Kristin L; Vaupel, James W; Törnwall, Outi; Johnson, Thomas E; Schreiber, Stefan; Lathrop, Mark; Skytthe, Axel; Westendorp, Rudi GJ; Christensen, Kaare; Gampe, Jutta; Nebel, Almut; Houwing-Duistermaat, Jeanine J; Slagboom, Pieternella Eline; Franceschi, Claudio; GEHA consortiumClear evidence exists for heritability of human longevity, and much interest is focused on identifying genes associated with longer lives. To identify such longevity alleles, we performed the largest genome-wide linkage scan thus far reported. Linkage analyses included 2118 nonagenarian Caucasian sibling pairs that have been enrolled in 15 study centers of 11 European countries as part of the Genetics of Healthy Aging (GEHA) project. In the joint linkage analyses, we observed four regions that show linkage with longevity; chromosome 14q11.2 (LOD = 3.47), chromosome 17q12-q22 (LOD = 2.95), chromosome 19p13.3-p13.11 (LOD = 3.76), and chromosome 19q13.11-q13.32 (LOD = 3.57). To fine map these regions linked to longevity, we performed association analysis using GWAS data in a subgroup of 1228 unrelated nonagenarian and 1907 geographically matched controls. Using a fixed-effect meta-analysis approach, rs4420638 at the TOMM40/APOE/APOC1 gene locus showed significant association with longevity (P-value = 9.6 × 10(-8) ). By combined modeling of linkage and association, we showed that association of longevity with APOEε4 and APOEε2 alleles explain the linkage at 19q13.11-q13.32 with P-value = 0.02 and P-value = 1.0 × 10(-5) , respectively. In the largest linkage scan thus far performed for human familial longevity, we confirm that the APOE locus is a longevity gene and that additional longevity loci may be identified at 14q11.2, 17q12-q22, and 19p13.3-p13.11. As the latter linkage results are not explained by common variants, we suggest that rare variants play an important role in human familial longevity.Item Open Access Global guideline for the diagnosis and management of the endemic mycoses: an initiative of the European Confederation of Medical Mycology in cooperation with the International Society for Human and Animal Mycology.(The Lancet. Infectious diseases, 2021-12) Thompson, George R; Le, Thuy; Chindamporn, Ariya; Kauffman, Carol A; Alastruey-Izquierdo, Ana; Ampel, Neil M; Andes, David R; Armstrong-James, Darius; Ayanlowo, Olusola; Baddley, John W; Barker, Bridget M; Lopes Bezerra, Leila; Buitrago, Maria J; Chamani-Tabriz, Leili; Chan, Jasper FW; Chayakulkeeree, Methee; Cornely, Oliver A; Cunwei, Cao; Gangneux, Jean-Pierre; Govender, Nelesh P; Hagen, Ferry; Hedayati, Mohammad T; Hohl, Tobias M; Jouvion, Grégory; Kenyon, Chris; Kibbler, Christopher C; Klimko, Nikolai; Kong, David CM; Krause, Robert; Lee Lee, Low; Meintjes, Graeme; Miceli, Marisa H; Rath, Peter-Michael; Spec, Andrej; Queiroz-Telles, Flavio; Variava, Ebrahim; Verweij, Paul E; Schwartz, Ilan S; Pasqualotto, Alessandro CThe global burden of the endemic mycoses (blastomycosis, coccidioidomycosis, emergomycosis, histoplasmosis, paracoccidioidomycosis, sporotrichosis, and talaromycosis) continues to rise yearly and these infectious diseases remain a leading cause of patient morbidity and mortality worldwide. Management of the associated pathogens requires a thorough understanding of the epidemiology, risk factors, diagnostic methods and performance characteristics in different patient populations, and treatment options unique to each infection. Guidance on the management of these infections has the potential to improve prognosis. The recommendations outlined in this Review are part of the "One World, One Guideline" initiative of the European Confederation of Medical Mycology. Experts from 23 countries contributed to the development of these guidelines. The aim of this Review is to provide an up-to-date consensus and practical guidance in clinical decision making, by engaging physicians and scientists involved in various aspects of clinical management.Item Open Access International Comparison of Poststroke Resource Use: A Longitudinal Analysis in Europe.(Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2015-10) Matchar, David B; Bilger, Marcel; Do, Young K; Eom, KirstenBackground
Long-term costs often represent a large proportion of the total costs induced by stroke, but data on long-term poststroke resource use are sparse, especially regarding the trajectory of costs by severity. We used a multinational longitudinal survey to estimate patterns of poststroke resource use by degree of functional disability and to compare resource use between regions.Methods
The Survey of Health, Ageing and Retirement in Europe (SHARE) is a multinational database of adults 50 years and older, which includes demographic information about respondents, age when stroke first occurred, current activity of daily living (ADL) limitations, and health care resource use in the year before interview. We modeled resource use with a 2-part regression for number of hospital days, home nursing hours, and paid and unpaid home caregiving hours.Results
After accounting for time since stroke, number of strokes and comorbidities, age, gender, and European regions, we found that poststroke resource use was strongly associated with ADL limitations. The duration since the stroke event was significantly associated only with inpatient care, and informal help showed significant regional heterogeneity across all ADL limitation levels.Conclusions
Poststroke physical deficits appear to be a strong driver of long-term resource utilization; treatments that decrease such deficits offer substantial potential for downline cost savings. Analyzing internationally comparable panel data, such as SHARE, provide valuable insight into long-term cost of stroke. More comprehensive international comparisons will require registries with follow-up, particularly for informal and formal home-based care.Item Open Access International variation in characteristics and clinical outcomes of patients with type 2 diabetes and heart failure: Insights from TECOS.(American heart journal, 2019-12) Bhatt, Ankeet S; Luo, Nancy; Solomon, Nicole; Pagidipati, Neha J; Ambrosio, Giuseppe; Green, Jennifer B; McGuire, Darren K; Standl, Eberhard; Cornel, Jan H; Halvorsen, Sigrun; Lopes, Renato D; White, Harvey D; Holman, Rury R; Peterson, Eric D; Mentz, Robert J; TECOS Study GroupInternational differences in management/outcomes among patients with type 2 diabetes and heart failure (HF) are not well characterized. We sought to evaluate geographic variation in treatment and outcomes among these patients. METHODS AND RESULTS: Among 14,671 participants in the Trial Evaluating Cardiovascular Outcomes with Sitagliptin (TECOS), those with HF at baseline and a documented ejection fraction (EF) (N = 1591; 10.8%) were categorized by enrollment region (North America, Latin America, Western Europe, Eastern Europe, and Asia Pacific). Cox models were used to examine the association between geographic region and the primary outcome of all-cause mortality (ACM) or hospitalization for HF (hHF) in addition to ACM alone. Analyses were stratified by those with EF <40% or EF ≥40%. The majority of participants with HF were enrolled in Eastern Europe (53%). Overall, 1,267 (79.6%) had EF ≥40%. β-Blocker (83%) and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker (86%) use was high across all regions in patients with EF <40%. During a median follow-up of 2.9 years, Eastern European participants had lower rates of ACM/hHF compared with North Americans (adjusted hazard ratio: 0.45; 95% CI: 0.32-0.64). These differences were seen only in the EF ≥40% subgroup and not the EF <40% subgroup. ACM was similar among Eastern European and North American participants (adjusted hazard ratio: 0.79; 95% CI: 0.44-1.45). CONCLUSIONS: Significant variation exists in the clinical features and outcomes of HF patients across regions in TECOS. Patients from Eastern Europe had lower risk-adjusted ACM/hHF than those in North America, driven by those with EF ≥40%. These data may inform the design of future international trials.Item Open Access Long-term survival and late deaths after hematopoietic cell transplantation for primary immunodeficiency diseases and inborn errors of metabolism.(Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation, 2012-09) Eapen, Mary; Ahn, Kwang Woo; Orchard, Paul J; Cowan, Morton J; Davies, Stella M; Fasth, Anders; Hassebroek, Anna; Ayas, Mouhab; Bonfim, Carmem; O'Brien, Tracey A; Gross, Thomas G; Horwitz, Mitchell; Horwitz, Edwin; Kapoor, Neena; Kurtzberg, Joanne; Majhail, Navneet; Ringden, Olle; Szabolcs, Paul; Veys, Paul; Baker, K ScottIt is uncertain whether late mortality rates after hematopoietic cell transplantation for severe combined immunodeficiency (SCID), non-SCID primary immunodeficiency diseases (non-SCID PIDD), and inborn errors of metabolism (IEM) return to rates observed in the general population, matched for age, sex, and nationality. We studied patients with SCID (n = 201), non-SCID PIDD (n = 405), and IEM (n = 348) who survived for at least 2 years after transplantation with normal T cell function (SCID) or >95% donor chimerism (non-SCID PIDD and IEM). Importantly, mortality rate was significantly higher in these patients compared with the general population for several years after transplantation. The rate decreased toward the normal rate in patients with SCID and non-SCID PIDD beyond 6 years after transplantation, but not in patients with IEM. Active chronic graft-versus-host disease at 2 years was associated with increased risk of late mortality for all diseases (hazard ratio [HR], 1.87; P = .05). In addition, late mortality was higher in patients with non-SCID PIDD who received T cell-depleted grafts (HR 4.16; P = .007) and in patients with IEM who received unrelated donor grafts (HR, 2.72; P = .03) or mismatched related donor grafts (HR, 3.76; P = .01). The finding of higher mortality rates in these long-term survivors for many years after transplantation confirms the need for long-term surveillance.Item Open Access Offside(2011-05-02) Arnstein, BenjaminFor nearly a century football has been emblematic of the United States and its society. This will be compared against soccer, which is far and away the most popular and important sport in Europe. The United States economy is theoretically a free-market system. In contrast, Europe’s economic system is rooted in regulated and interventionist principles. Interestingly, the economic policies of soccer and football as industries do not follow the economic philosophies predominant in their respective home regions; in many ways they actually operate directly to the contrary. In both soccer and football the inflow and outflow of capital are derived primarily from the same three sources: media and televisions rights, merchandising and sponsorship rights, and player salaries. Examining these areas shows the ways in which the economic structures confound societal expectations. The four primary reasons behind this paradox are: the different structures of the governing bodies, the different ownership structures of the teams/clubs, the different levels of competition between teams in each region, and the difference in length of outlook for economic decision making by those in charge of the two sports. The current consequences are superteams causing unbalanced competition in European soccer and a potential work stoppage in the NFL.Item Open Access Practice variations in the conduct of hypothermic circulatory arrest for adult aortic arch repair: focus on an emerging European paradigm.(Heart, lung and vessels, 2014-01) Gutsche, JT; Feinman, J; Silvay, G; Patel, PP; Ghadimi, K; Landoni, G; Yue, Y; Augoustides, JGTIntroduction
Hypothermic circulatory arrest for adult aortic arch repair is still high-risk. Despite decades of clinical experience, significant practice variations exist around the world. These practice variations in hypothermic circulatory arrest may offer multiple opportunities to improve practice. The hypothesis of this study was that the current conduct of adult hypothermic circulatory arrest in Europe has significant variations that might suggest opportunities for risk reduction.Methods
An adult hypothermic circulatory arrest questionnaire was developed and then administered at thoracic aortic sessions at international conferences during 2010 in Beijing and Milan. The data was collected, abstracted and analyzed.Results
The majority of the 105 respondents were anesthesiologists based in Europe and China. The typical adult aortic arch repair in Europe was with hypothermic circulatory arrest at moderate hypothermia utilizing bilateral antegrade cerebral perfusion, typically monitored with radial arterial pressure and cerebral oximetry. Brain temperature was frequently measured at distal locations. The preferred neuroprotective agents were steroids, propofol and thiopental.Conclusions
The opportunities for outcome improvement in this emerging European paradigm of tepid adult aortic arch repair include nasal/tympanic temperature measurement and adoption of unilateral antegrade cerebral perfusion monitored with radial artery pressure and cerebral oximetry. The publication of an evidence-based consensus would enhance these practice-improvement opportunities.Item Open Access Prevalence and Etiology of Community-acquired Pneumonia in Immunocompromised Patients.(Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019-04) Di Pasquale, Marta Francesca; Sotgiu, Giovanni; Gramegna, Andrea; Gramegna, Andrea; Radovanovic, Dejan; Terraneo, Silvia; Reyes, Luis F; Rupp, Jan; González Del Castillo, Juan; Blasi, Francesco; Aliberti, Stefano; Restrepo, Marcos I; GLIMP InvestigatorsBackground
The correct management of immunocompromised patients with pneumonia is debated. We evaluated the prevalence, risk factors, and characteristics of immunocompromised patients coming from the community with pneumonia.Methods
We conducted a secondary analysis of an international, multicenter study enrolling adult patients coming from the community with pneumonia and hospitalized in 222 hospitals in 54 countries worldwide. Risk factors for immunocompromise included AIDS, aplastic anemia, asplenia, hematological cancer, chemotherapy, neutropenia, biological drug use, lung transplantation, chronic steroid use, and solid tumor.Results
At least 1 risk factor for immunocompromise was recorded in 18% of the 3702 patients enrolled. The prevalences of risk factors significantly differed across continents and countries, with chronic steroid use (45%), hematological cancer (25%), and chemotherapy (22%) the most common. Among immunocompromised patients, community-acquired pneumonia (CAP) pathogens were the most frequently identified, and prevalences did not differ from those in immunocompetent patients. Risk factors for immunocompromise were independently associated with neither Pseudomonas aeruginosa nor non-community-acquired bacteria. Specific risk factors were independently associated with fungal infections (odds ratio for AIDS and hematological cancer, 15.10 and 4.65, respectively; both P = .001), mycobacterial infections (AIDS; P = .006), and viral infections other than influenza (hematological cancer, 5.49; P < .001).Conclusions
Our findings could be considered by clinicians in prescribing empiric antibiotic therapy for CAP in immunocompromised patients. Patients with AIDS and hematological cancer admitted with CAP may have higher prevalences of fungi, mycobacteria, and noninfluenza viruses.Item Open Access Quantitative imaging test approval and biomarker qualification: interrelated but distinct activities.(Radiology, 2011-06) Buckler, Andrew J; Bresolin, Linda; Dunnick, N Reed; Sullivan, Daniel C; Aerts, Hugo JWL; Bendriem, Bernard; Bendtsen, Claus; Boellaard, Ronald; Boone, John M; Cole, Patricia E; Conklin, James J; Dorfman, Gary S; Douglas, Pamela S; Eidsaunet, Willy; Elsinger, Cathy; Frank, Richard A; Gatsonis, Constantine; Giger, Maryellen L; Gupta, Sandeep N; Gustafson, David; Hoekstra, Otto S; Jackson, Edward F; Karam, Lisa; Kelloff, Gary J; Kinahan, Paul E; McLennan, Geoffrey; Miller, Colin G; Mozley, P David; Muller, Keith E; Patt, Rick; Raunig, David; Rosen, Mark; Rupani, Haren; Schwartz, Lawrence H; Siegel, Barry A; Sorensen, A Gregory; Wahl, Richard L; Waterton, John C; Wolf, Walter; Zahlmann, Gudrun; Zimmerman, BrianQuantitative imaging biomarkers could speed the development of new treatments for unmet medical needs and improve routine clinical care. However, it is not clear how the various regulatory and nonregulatory (eg, reimbursement) processes (often referred to as pathways) relate, nor is it clear which data need to be collected to support these different pathways most efficiently, given the time- and cost-intensive nature of doing so. The purpose of this article is to describe current thinking regarding these pathways emerging from diverse stakeholders interested and active in the definition, validation, and qualification of quantitative imaging biomarkers and to propose processes to facilitate the development and use of quantitative imaging biomarkers. A flexible framework is described that may be adapted for each imaging application, providing mechanisms that can be used to develop, assess, and evaluate relevant biomarkers. From this framework, processes can be mapped that would be applicable to both imaging product development and to quantitative imaging biomarker development aimed at increasing the effectiveness and availability of quantitative imaging.http://radiology.rsna.org/lookup/suppl/doi:10.1148/radiol.10100800/-/DC1.Item Open Access Revenge of the Radical Right: Why Minority Accommodation Mobilizes Extremist Voting(2012) Siroky, Lenka BustikovaHow can we explain variation in support for radical right parties over time and across post-communist democracies? This project suggests that support for radical right parties is driven by the politics of accommodation, and is aimed at counteracting the political inroads, cultural concessions and economic gains of politically organized minorities. It differs from other studies of extremist politics in three primary respects: (1) Unlike current approaches that focus on competition between the extreme and mainstream parties, I emphasize dynamics between the radical right party and non- proximate parties that promote minority rights. (2) Several approaches argue that xenophobia drives support for the radical right, whereas I show that xenophobia is not a distinct feature of the radical right party support base; what differentiates radical right voters from other voters is opposition to governmental transfers towards politically organized minorities. (3) I endogenize issue salience and identify coalition politics - i.e., coalitions of mainstream parties and parties supporting minority protection - as a key mechanism that increases the salience of identity issues in political competition, and benefits radical right parties. The project tests these propositions empirically, and finds supportive evidence using two unique micro-level surveys and an original party-election-level data set covering all post-communist democracies.
Item Open Access THE FUTURE OF BIG OIL IN THE HYDROGEN ECONOMY(2021-04-30) Koutsogeorgas, Panayiotis; Ripecky, ZoëGlobally, oil and gas companies have approached hydrogen fuel with varying levels of interest and investment. In Europe, where policymakers have earmarked large sums of investment in the future of hydrogen, oil majors have been generally more proactive about incorporating hydrogen into their corporate strategies. US policymakers and oil majors have overall been less focused on hydrogen, but the US has some unique conditions that may be favorable to an expanded hydrogen industry. This project outlines the current positions of oil majors when it comes to hydrogen. It explores the unique challenges and opportunities that exist for traditional oil and gas companies, and how oil majors might adapt their infrastructure and workforce to embrace a hydrogen future.