Impact of clinical phenotypes on management and outcomes in European atrial fibrillation patients: a report from the ESC-EHRA EURObservational Research Programme in AF (EORP-AF) General Long-Term Registry

Background: Epidemiological studies in atrial fibrillation (AF) illustrate that clinical complexity increase the risk of major adverse outcomes. We aimed to describe European AF patients\u2019 clinical phenotypes and analyse the differential clinical course. Methods: We performed a hierarchical cluster analysis based on Ward\u2019s Method and Squared Euclidean Distance using 22 clinical binary variables, identifying the optimal number of clusters. We investigated differences in clinical management, use of healthcare resources and outcomes in a cohort of European AF patients from a Europe-wide observational registry. Results: A total of 9363 were available for this analysis. We identified three clusters: Cluster 1 (n = 3634; 38.8%) characterized by older patients and prevalent non-cardiac comorbidities; Cluster 2 (n = 2774; 29.6%) characterized by younger patients with low prevalence of comorbidities; Cluster 3 (n = 2955;31.6%) characterized by patients\u2019 prevalent cardiovascular risk factors/comorbidities. Over a mean follow-up of 22.5 months, Cluster 3 had the highest rate of cardiovascular events, all-cause death, and the composite outcome (combining the previous two) compared to Cluster 1 and Cluster 2 (all P <.001). An adjusted Cox regression showed that compared to Cluster 2, Cluster 3 (hazard ratio (HR) 2.87, 95% confidence interval (CI) 2.27\u20133.62; HR 3.42, 95%CI 2.72\u20134.31; HR 2.79, 95%CI 2.32\u20133.35), and Cluster 1 (HR 1.88, 95%CI 1.48\u20132.38; HR 2.50, 95%CI 1.98\u20133.15; HR 2.09, 95%CI 1.74\u20132.51) reported a higher risk for the three outcomes respectively. Conclusions: In European AF patients, three main clusters were identified, differentiated by differential presence of comorbidities. Both non-cardiac and cardiac comorbidities clusters were found to be associated with an increased risk of major adverse outcomes

L’émotion et le réel

Modzelewski Karol, Maziarski Jack, Li P. L’émotion et le réel. In: Autogestions, NS N°5, 1981. Pologne : la brèche ? pp. 45-58

Rhetoric and the cultural trauma: An analysis of Jan T Gross’ book Fear. Anti-Semitism in Poland after Auschwitz

This study deals with the historian Jan T Gross’ book Fear, published in 2006 in the United States and in 2008 in Poland. The book deserves special attention because it became one of the most discussed historical works in post-Communist Poland. In Fear, just as in his previous book Neighbors (2000), Gross challenged the Poles’ view of themselves as solely innocent victims of German Nazism and argued that anti-Semitism could and did lead them to kill Jews, both during and after the war. The author of the article seeks to answer the question as to what made the Poles react so strongly to Fear. She argues that the reasons are not only to be found in the book’s message and the political context in which it appeared but also in the mode of historical representation applied by Gross. The specific rhetoric of Fear has been noted by its critics, but no one analysed it closely. This study intends to fill that gap. The present author’s thesis is that in Fear, Gross uses the rhetorical design of a deliberative speech, and by so doing, anchors his narrative in the present and demands future action by his readers. This combination of telling about past events and pointing to their present relevance makes his narrative performance very different from conventional historiography. The value of Gross’ work lies not primarily in his contribution to the body of existing knowledge but in its functionality and performativit