Social structure and social policy: About the institutional flexibility of three modern welfare states

This paper addresses the question of the institutional flexibility of three major European welfare states. Using Data from the second and fifth wave of the Luxembourg Income Study (LIS), we measure first how effectively the German, British and Italian welfare state have responded changes in their country-specific poverty risks profile. Further, we apply a macro-simulation to evaluate the performance of the three welfare states in terms of poverty reduction. We find that the social policy institutions of Germany and Britain are more able to deal successfully with changing age and household structures as the Italian welfare state

Years of life that could be saved from prevention of hepatocellular carcinoma

BACKGROUND: Hepatocellular carcinoma (HCC) causes premature death and loss of life expectancy worldwide. Its primary and secondary prevention can result in a significant number of years of life saved. AIM: To assess how many years of life are lost after HCC diagnosis. METHODS: Data from 5346 patients with first HCC diagnosis were used to estimate lifespan and number of years of life lost after tumour onset, using a semi-parametric extrapolation having as reference an age-, sex- and year-of-onset-matched population derived from national life tables. RESULTS: Between 1986 and 2014, HCC lead to an average of 11.5 years-of-life lost for each patient. The youngest age-quartile group (18-61 years) had the highest number of years-of-life lost, representing approximately 41% of the overall benefit obtainable from prevention. Advancements in HCC management have progressively reduced the number of years-of-life lost from 12.6 years in 1986-1999, to 10.7 in 2000-2006 and 7.4 years in 2007-2014. Currently, an HCC diagnosis when a single tumour <2 cm results in 3.7 years-of-life lost while the diagnosis when a single tumour 65 2 cm or 2/3 nodules still within the Milan criteria, results in 5.0 years-of-life lost, representing the loss of only approximately 5.5% and 7.2%, respectively, of the entire lifespan from birth. CONCLUSIONS: Hepatocellular carcinoma occurrence results in the loss of a considerable number of years-of-life, especially for younger patients. In recent years, the increased possibility of effectively treating this tumour has improved life expectancy, thus reducing years-of-life lost

Neurofilament light chain and glial fibrillary acidic protein as diagnostic and prognostic biomarkers in epileptic seizures and epilepsy : A ystematic review

Epileptology − with epilepsy as one of the most common neurological diseases − has an urgent need for easily accessible biomarkers to improve diagnosis, prognosis and therapeutic monitoring. Neurofilament light chain (NfL) and Glial Fibrillary Acidic Protein (GFAP) have emerged as promising fluid biomarkers in various neurological disorders. Their potential role in epileptic seizures and epilepsy remains largely unexplored. To assess the current state of research on this topic we comprehensively searched the published literature for studies on GFAP and/or NfL in cerebrospinal fluid and/or blood in adult humans with epileptic seizures, status epilepticus or epilepsy (last data base search on 10th of May 2024). We identified a total of 2285 publications of which 19 fulfilled our search criteria. The studies targeted various outcomes such as prognosis in status epilepticus, differentiation of seizure semiology and etiology, differentiation of epileptic seizures from non-epileptic conditions, prediction of epilepsy in autoimmune epilepsy, after a stroke or after a first unprovoked seizure, the role of the time interval from seizure to sampling, the association with disease duration as well as seizure frequency and the influence of seizure suppressing medication. The results are heterogeneous but indicate promising applications for both NfL and GFAP in diagnosis and prognostication of patients with epileptic seizures and epilepsy. In the present review we summarize the current evidence, future perspectives, but also limitations, of NfL and GFAP as fluid biomarkers in epilepsy and epileptic seizures

Neurofilament light chain and glial fibrillary acidic protein as diagnostic and prognostic biomarkers in epileptic seizures and epilepsy: A systematic review

Epileptology − with epilepsy as one of the most common neurological diseases − has an urgent need for easily accessible biomarkers to improve diagnosis, prognosis and therapeutic monitoring. Neurofilament light chain (NfL) and Glial Fibrillary Acidic Protein (GFAP) have emerged as promising fluid biomarkers in various neurological disorders. Their potential role in epileptic seizures and epilepsy remains largely unexplored. To assess the current state of research on this topic we comprehensively searched the published literature for studies on GFAP and/or NfL in cerebrospinal fluid and/or blood in adult humans with epileptic seizures, status epilepticus or epilepsy (last data base search on 10th of May 2024). We identified a total of 2285 publications of which 19 fulfilled our search criteria. The studies targeted various outcomes such as prognosis in status epilepticus, differentiation of seizure semiology and etiology, differentiation of epileptic seizures from non-epileptic conditions, prediction of epilepsy in autoimmune epilepsy, after a stroke or after a first unprovoked seizure, the role of the time interval from seizure to sampling, the association with disease duration as well as seizure frequency and the influence of seizure suppressing medication. The results are heterogeneous but indicate promising applications for both NfL and GFAP in diagnosis and prognostication of patients with epileptic seizures and epilepsy. In the present review we summarize the current evidence, future perspectives, but also limitations, of NfL and GFAP as fluid biomarkers in epilepsy and epileptic seizures

Structure II gas hydrates found below the bottom-simulating reflector

Gas hydrates are a major component in the organic carbon cycle. Their stability is controlled by temperature, pressure, water chemistry, and gas composition. The bottom-simulating reflector (BSR) is the primary seismic indicator of the base of hydrate stability in continental margins. Here we use seismic, well log, and core data from the convergent margin offshore NW Borneo to demonstrate that the BSR does not always represent the base of hydrate stability and can instead approximate the boundary between structure I hydrates above and structure II hydrates below. At this location, gas hydrate saturation below the BSR is higher than above and a process of chemical fractionation of the migrating free gas is responsible for the structure I-II transition. This research shows that in geological settings dominated by thermogenic gas migration, the hydrate stability zone may extend much deeper than suggested by the BSR

Prevention and treatment of ischaemic and haemorrhagic stroke in people with diabetes mellitus: a focus on glucose control and comorbidities

Diabetes mellitus is a significant risk factor for both ischaemic and haemorrhagic stroke, affecting up to a third of individuals with cerebrovascular diseases. Beyond being a risk factor for stroke, diabetes and hyperglycaemia have a negative impact on outcomes after ischaemic and haemorrhagic stroke. Hyperglycaemia during the acute ischaemic stroke phase is associated with a higher risk of haemorrhagic transformation and poor functional outcome, with evidence in favour of early intervention to limit and manage severe hyperglycaemia. Similarly, intensive glucose control nested in a broader bundle of care, including blood pressure, coagulation and temperature control, can provide substantial benefit for clinical outcomes after haemorrhagic stroke. As micro- and macrovascular complications are frequent in people with diabetes, cardiovascular prevention strategies also need to consider tailored treatment. In this regard, the broader availability of sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists can allow tailored treatments, particularly for those with heart failure and chronic kidney disease as comorbidities. Here, we review the main concepts of hyperacute stroke management and CVD prevention among people with diabetes, capitalising on results from large studies and RCTs to inform clinicians on preferred treatments. Graphical Abstract

Bilateral extensive corticospinal tract lesions in MOG antibody–associated disease

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A call for academic pragmatic clinical trials to address open questions in migraine prevention

: The migraine treatment landscape has seen significant advancements in recent years, including the introduction of novel preventive agents specifically targeting the disease. These new treatments offer improved efficacy and tolerability, potentially addressing the issue of poor treatment adherence commonly observed with conventional preventatives. In this context, pragmatic trials emerge as a critical tool for advancing migraine care, offering a real-world approach to evaluating open clinical questions at the same time as avoiding the biases of real-world observational evidence. By prioritizing external validity and patient-centered outcomes, pragmatic trials provide valuable insights into the advantages of new treatments in improving migraine care. Possible applications of pragmatic trials in migraine research include head-to-head comparisons, evaluation of combination therapies, assessment of treatment sequences and switch, testing the added value of patient-reported outcomes, investigation of long-term effectiveness and on optimal treatment duration, understanding the role of preventive treatments in altering the course of migraine and preventing progression, and cost-effectiveness analyses. Pragmatic trials allow for the assessment of interventions in diverse patient populations and healthcare settings, enhancing the generalizability of findings and informing evidence-based clinical practice. As such, pragmatic trials represent an excellent tool to bridge the gap between placebo-controlled trials and real-world practice and should receive consideration for funding, especially by public institutions such as universities, national health services, and charities