United in Diversity? A Study on the Implementation of Sanctions in the European Union

The implementation of European Union (EU) policies has been investigated for several policy areas, but Decisions made under the Common Foreign and Security Policy (CFSP) have rarely been considered. While many CFSP measures are applicable throughout the EU without the need for further action on the domestic level, some Decisions must be implemented by Council Regulations. These Council Regulations adopted with the intent to implement CFSP Decisions have qualities of Directives, which delegate implementing tasks to member states and require transposition. The aim of this article is to investigate whether restrictive measures imposed by the EU are uniformly implemented across the member states, and, if not, to what extent implementation performance varies. We observe significant differences in implementation performance across member states. The findings of this article are twofold. First, we claim that implementation and compliance studies should involve CFSP decisions more systematically. Second, empirical confirmation is provided of how uneven transposition and application occurs also in CFSP matters. This study is based on empirical work that consisted of desk research and semi-structured interviews with national competent authorities of 21 EU member states taking place between March 2020 and January 2021

Automatic segmentation of MR brain images with a convolutional neural network

Automatic segmentation in MR brain images is important for quantitative analysis in large-scale studies with images acquired at all ages. This paper presents a method for the automatic segmentation of MR brain images into a number of tissue classes using a convolutional neural network. To ensure that the method obtains accurate segmentation details as well as spatial consistency, the network uses multiple patch sizes and multiple convolution kernel sizes to acquire multi-scale information about each voxel. The method is not dependent on explicit features, but learns to recognise the information that is important for the classification based on training data. The method requires a single anatomical MR image only. The segmentation method is applied to five different data sets: coronal T2-weighted images of preterm infants acquired at 30 weeks postmenstrual age (PMA) and 40 weeks PMA, axial T2- weighted images of preterm infants acquired at 40 weeks PMA, axial T1-weighted images of ageing adults acquired at an average age of 70 years, and T1-weighted images of young adults acquired at an average age of 23 years. The method obtained the following average Dice coefficients over all segmented tissue classes for each data set, respectively: 0.87, 0.82, 0.84, 0.86 and 0.91. The results demonstrate that the method obtains accurate segmentations in all five sets, and hence demonstrates its robustness to differences in age and acquisition protocol

Mapping public support for the varieties of differentiated integration

This article maps and investigates public support for different types of differentiated integration (DI) in the European Union. We examine citizens' preferences for DI using novel survey data from eight EU member states. The data reveals substantive differences in support for different types of DI. Factor analyses reveal two dimensions that seem to structure citizens' evaluations of DI. The first dimension relates to the effect of DI on the European integration project, the second concerns the safeguarding of national autonomy. Citizens' attitudes on this second dimension vary substantively across countries. General EU support is the most important correlate of DI support, correlating positively with the first and negatively with the second dimension. Our results underline that while citizens generally care about the fairness of DI, balancing out their different concerns can be a challenging political task

A Case of Anti-SAE1 Dermatomyositis

INTRODUCTION: Anti-SAE1 antibodies have a low prevalence in dermatomyositis patients. Case Description. A 61-year-old woman presented with progressive shortness of breath, arthralgia, heliotrope rash, Gottron's papules, and erythematous rash. She had an interstitial lung disease (ILD) with a significant decrease in lung function. There was no muscle involvement. Immunological laboratory test results showed strongly positive anti-SAE1 antibodies. Glucocorticoid treatment resulted in remission of dermatomyositis. CONCLUSION: Anti-SAE antibodies in dermatomyositis patients are closely linked to unique clinical features

Die technische Mündigkeit von Schüler/-innen zum Ende der Sek. I im internationalen Vergleich

In internationaler Zusammenarbeit hat eine Forschergruppe ein Aufgaben-Entwicklungsmodell konzeptualisiert, auf dessen Basis ein Testinstrument zur Erfassung der technischen Mündigkeit von Schüler/-innen zum Ende der Sekundarstufe I abgeleitet wurde. Mit diesem Testinstrument wurden 270 Schülerinnen und Schülern aus Deutschland, der Schweiz, Luxemburg, den Niederlanden und England getestet. Die Ergebnisse zeigen, dass die technische Mündigkeit von Schüler/-innen im Alter von 13-16 Jahren nur mäßig ausgeprägt ist. Der durchschnittliche Anteil von 25 % der Aufgaben, die mit hoher Sicherheit falsch beantwortet wurden, lässt den Schluss zu, dass sich neben fehlendem Wissen auch eine relativ hohe Anzahl von Misskonzepten bei den Schüler/-innen verfestigt hat. Interessanterweise zeigen sich dabei keine großen Unterschiede in Bezug auf die einzelnen Länder und das Geschlecht. Schlüsselwörter: Technische Mündigkeit, Testinstrument, internationa

Socio-economic disparities in hospital care among Dutch patients with diabetes mellitus

Aim: Socio-economic status (SES) influences diabetes onset, progression and treatment. In this study, the associations between SES and use of hospital care were assessed, focusing on hospitalizations, technology and cardiovascular complications. Materials and Methods: This was an observational cohort study comprising 196 695 patients with diabetes (all types and ages) treated in 65 hospitals across the Netherlands from 2019 to 2020 using reimbursement data. Patients were stratified in low, middle, or high SES based on residential areas derived from four-digit zip codes. Results: Children and adults with low SES were hospitalized more often than patients with middle or high SES (children: 22%, 19% and 15%, respectively; p &lt;.001, adults: 28%, 25% and 23%; p &lt;.001). Patients with low SES used the least technology: no technology in 48% of children with low SES versus 40% with middle SES and 38% with high SES. In children, continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (rtCGM) use was higher in high SES {CSII: odds ratio (OR) 1.54 [95% confidence interval (CI) 1.35-1.76]; p &lt;.001; rtCGM OR 1.39 [95% CI 1.20-1.61]; p &lt;.001} and middle SES [CSII: OR 1.41 (95% CI 1.24-1.62); p &lt;.001; rtCGM: OR 1.27 (95% CI 1.09-1.47); p =.002] compared with low SES. Macrovascular (OR 0.78 (95% CI 0.75-0.80); p &lt;.001) and microvascular complications [OR 0.95 (95% CI 0.93-0.98); p &lt;.001] occurred less in high than in low SES. Conclusions: Socio-economic disparities were observed in patients with diabetes treated in Dutch hospitals, where basic health care is covered. Patients with low SES were hospitalized more often, used less technology, and adults with high SES showed fewer cardiovascular complications. These inequities warrant attention to guarantee equal outcomes for all.</p

Socio-economic disparities in hospital care among Dutch patients with diabetes mellitus

Aim: Socio-economic status (SES) influences diabetes onset, progression and treatment. In this study, the associations between SES and use of hospital care were assessed, focusing on hospitalizations, technology and cardiovascular complications. Materials and Methods: This was an observational cohort study comprising 196 695 patients with diabetes (all types and ages) treated in 65 hospitals across the Netherlands from 2019 to 2020 using reimbursement data. Patients were stratified in low, middle, or high SES based on residential areas derived from four-digit zip codes. Results: Children and adults with low SES were hospitalized more often than patients with middle or high SES (children: 22%, 19% and 15%, respectively; p &lt;.001, adults: 28%, 25% and 23%; p &lt;.001). Patients with low SES used the least technology: no technology in 48% of children with low SES versus 40% with middle SES and 38% with high SES. In children, continuous subcutaneous insulin infusion (CSII) and real-time continuous glucose monitoring (rtCGM) use was higher in high SES {CSII: odds ratio (OR) 1.54 [95% confidence interval (CI) 1.35-1.76]; p &lt;.001; rtCGM OR 1.39 [95% CI 1.20-1.61]; p &lt;.001} and middle SES [CSII: OR 1.41 (95% CI 1.24-1.62); p &lt;.001; rtCGM: OR 1.27 (95% CI 1.09-1.47); p =.002] compared with low SES. Macrovascular (OR 0.78 (95% CI 0.75-0.80); p &lt;.001) and microvascular complications [OR 0.95 (95% CI 0.93-0.98); p &lt;.001] occurred less in high than in low SES. Conclusions: Socio-economic disparities were observed in patients with diabetes treated in Dutch hospitals, where basic health care is covered. Patients with low SES were hospitalized more often, used less technology, and adults with high SES showed fewer cardiovascular complications. These inequities warrant attention to guarantee equal outcomes for all.</p