Quantitative CrossNational Research Methods

Quantitative nation comparisons pose inevitable trade-offs. One is that much of the contextual reality of individual nations is sacrificed for the sake of broader generalization. We fail to capture the uniqueness that defines a nation’s culture, historical heritage, and endemic logic. The interpretation of a variable may, indeed, only be possible when its is studied contextually (Ragin, 1987; and Lieberson, 1991). Boolean analysis, as Ragin argues, helps overcome this dilemma. It has advantages, such as its ability to build conjunctural models with very few cases, and its ability to analyze non-events. But it needs to be guided by strong theory and substantial knowledge, its applicability is limited to relatively few cases, and it may be too biased in favor of non-additive, conjunctural models. For an empirical application, see Ragin (1994). See also Section 2.3, no. 72. A second trade-off has to do with the often limited number of observations available, especially in studies of advanced (OECD) democracies where the N rarely exceeds 25. In broader World comparisons, however, the N approaches 200. Many attempt to supplement few nations with over-time data, as in the case of pooled cross sectiona

Carotid Plaque Vulnerability Assessed by Combined Shear Wave Elastography and Ultrafast Doppler Compared to Histology

International audienceUltrafast ultrasound imaging (UUI) provides an estimation of carotid plaque stiffness by shear wave elastography (SWE) and the quantification of wall shear stress (WSS) by ultrafast Doppler. We aimed to evaluate the combined criteria of plaque stiffness and WSS applied on the plaque as potential biomarkers of plaque vulnerability assessed by histology. We included patients for whom carotid endarterectomy had been decided by a multidisciplinary team. UUI was performed within 48 h before surgery, and acquisitions were obtained on a carotid longitudinal view. After endarterectomy, gross examination and histological analysis were performed on each removed plaque. Forty-six plaques with SWE data and 29 with WSS data were analyzed. Histological analysis revealed 29 vulnerable and 17 stable plaques. Gray-scale median analysis by B-mode, mean, and standard deviation of stiffness by SWE did not differ between vulnerable and stable plaques. SWE analysis revealed that the percentage of stiffness range of 3-5 m/s was significantly increased in vulnerable plaques (p = 0.048). WSS alone showed no difference between stable and vulnerable plaques regardless of the segment of the plaque which was analyzed. A multiparametric score using maximal WSS at the peak of the plaque associated with SWE texture analysis parameters was calculated by stepwise regression, leading to a score with a sensitivity of 80% and a specificity of 78%. Area under the receiver operating characteristics curve was 0.85. A multiparameter scoring system including plaque stiffness and flow analysis using UUI allows to effectively identify histologically vulnerable carotid plaques. ClinicalTrials.gov Identifier: NCT03234257