Internal Migration and Regional Population Dynamics in Europe: Estonia Case Study

Estonia has experienced a long-lasting and strong influence of international migration on regional population growth. Post-war immigrants account for about 36 per cent of the total population, and are concentrated in larger cities of Northern Estonia. Regionally, the relative proportions of the native-born and immigrant origin sub-populations are important for the understanding of population change and internal migration flows in the 1980-1990s. In Estonia, the quality of migration data requires careful assessment. The preservation of Soviet-type record-keeping has reduced data quality in the 1990s, already low, and use of the data should keep data quality problems in mind. Otherwise, false conclusions can be reached. To describe internal migration patterns, it has proved technically feasible and very useful to disaggregate the county population into rural and urban components, and correspondingly, the migration flows into four directions (urban-urban, urban-rural, rural-urban and rural-rural). During the 1980s the pattern of population growth and internal migration has changed in Estonia. Reflecting the turnaround in long-term population processes, migration development reached the advanced stage with more or less regionally balanced in- and out-migration flows and decreasing importance of net migration. Accordingly, to understand current trends and patterns, explanations must be sought from the 1980s which has served a starting point for the present trends rather than from the period of economic transition in the 1990s. As a part of the turnaround, the century-long persistent rural depopulation has come to an end and the moderate growth has started reflecting natural population increase as well as deurbanization. In the 1980s two developments have occurred in parallel: migratory increase of rural population led by a deurbanizing native-born population, and continued urban population growth as a result of the population momentum of pre-transition immigrants. In future decades, the urban deconcentration will probably be the underlying trend in Estonia. In Estonia, noticeable proportion of territory and population is located in islands. However, the island population does not show any systematic difference in the type of internal migration. Particularly, the depopulation of island populations, observed in several comparable European cases, is not occurring. Each life-course stage was found to have its specific migration pattern, more stable than the pattern for the total population. In many cases the changes of internal migration are determined by the change in the proportion of population in different life-course stages. Additionally, the life-course approach has been useful in demonstrating the features of the present Estonian internal migration pattern which appear closer to the countries of comparable in demographic development, more or less regardless of the significant differences in the level of economic development. Among life-course groups, in Estonia the older working age population was characterized by the strongest deurbanization intensities in 1995. The same group has also undergone the largest modification of migration pattern during the economic transition (1987-1995)

Statistical Storm Time Examination Of Mlt-Dependent Plasmapause Location Derived From Image Euv

The location of the outer edge of the plasmasphere (the plasmapause) as a function of geomagnetic storm time is identified and investigated statistically in regard to the solar wind driver. Imager for Magnetopause‐to‐Aurora Global Exploration (IMAGE) extreme ultraviolet (EUV) data are used to create an automated method that locates and extracts the plasmapause. The plasmapause extraction technique searches a set range of possible plasmasphere densities for a maximum gradient. The magnetic local time (MLT)‐dependent plasmapause results are compared to manual extraction results. The plasmapause results from 39 intense storms are examined along a normalized epoch storm timeline to determine the average plasmapause L shell as a function of MLT and storm time. The average extracted plasmapause L shell follows the expected storm time plasmapause behavior. The results show that during the main phase, the plasmapause moves earthward and a plasmaspheric drainage plume forms near dusk and across the dayside during strong convection. During the recovery phase, the plume rejoins the corotationally driven plasma while the average plasmapause location moves farther from the Earth. The results are also examined in terms of the solar wind driver. We find evidence that shows that the different categories of solar wind drivers result in different plasmaspheric configurations. During magnetic cloud‐driven events the plasmaspheric drainage plume appears at the start of the main phase. During sheath‐driven events the plume forms later but typically extends further in MLT.Key PointsDeveloped an automated procedure to extract plasmapause from IMAGE EUV imagesValidate and evaluate results using statistical analysis of 39 intense stormsShow that plasmasphere dynamics vary systematically with CME‐v‐CIR drivin

Detected troponin elevation is associated with high early mortality after lung resection for cancer

BACKGROUND: Myocardial infarction can be difficult to diagnose after lung surgery. As recent diagnostic criteria emphasize serum cardiac markers (in particular serum troponin) we set out to evaluate its clinical utility and to establish the long term prognostic impact of detected abnormal postoperative troponin levels after lung resection. METHODS: We studied a historic cohort of patients with primary lung cancer who underwent intended surgical resection. Patients were grouped according to known postoperative troponin status and survival calculated by Kaplan Meier method and compared using log rank. Parametric survival analysis was used to ascertain independent predictors of mortality. RESULTS: From 2001 to 2004, a total of 207 patients underwent lung resection for primary lung cancer of which 14 (7%) were identified with elevated serum troponin levels within 30 days of surgery, with 9 (64%) having classical features of myocardial infarction. The median time to follow up (interquartile range) was 22 (1 to 52) months, and the one and five year survival probabilities (95% CI) for patients without and with postoperative troponin elevation were 92% (85 to 96) versus 60% (31 to 80) and 61% (51 to 71) versus 18% (3 to 43) respectively (p < 0.001). T stage and postoperative troponin elevation remained independent predictors of mortality in the final multivariable model. The acceleration factor for death of elevated serum troponin after adjusting for tumour stage was 9.19 (95% CI 3.75 to 22.54). CONCLUSION: Patients with detected serum troponin elevation are at high risk of early mortality with or without symptoms of myocardial infarction after lung resection

Ticagrelor versus clopidogrel in patients with acute coronary syndromes intended for non-invasive management: substudy from prospective randomised PLATelet inhibition and patient Outcomes (PLATO) trial

Objective To evaluate efficacy and safety outcomes in patients in the PLATelet inhibition and patient Outcomes (PLATO) trial who at randomisation were planned for a non-invasive treatment strategy

Green tea halts progression of cardiac transthyretin amyloidosis: an observational report

BACKGROUND: Treatment options in patients with amyloidotic transthyretin (ATTR) cardiomyopathy are limited. Epigallocatechin-3-gallate (EGCG), the most abundant catechin in green tea (GT), inhibits fibril formation from several amyloidogenic proteins in vitro. Thus, it might also halt progression of TTR amyloidosis. This is a single-center observational report on the effects of GT consumption in patients with ATTR cardiomopathy. METHODS: 19 patients with ATTR cardiomyopathy were evaluated by standard blood tests, echocardiography, and cardiac MRI (n = 9) before and after consumption of GT and/or green tea extracts (GTE) for 12 months. RESULTS: Five patients were not followed up for reasons of death (n = 2), discontinuation of GT/GTE consumption (n = 2), and heart transplantation (n = 1). After 12 months no increase of left ventricular (LV) wall thickness and LV myocardial mass was observed by echocardiography. In the subgroup of patients evaluated by cardiac MRI a mean decrease of LV myocardial mass (-12.5 %) was detected in all patients. This was accompanied by an increase of mean mitral annular systolic velocity of 9 % in all 14 patients. Total cholesterol (191.9 ± 8.9 vs. 172.7 ± 9.4 mg/dL; p < 0.01) and LDL cholesterol (105.8 ± 7.6 vs. 89.5 ± 8.0 mg/dL; p < 0.01) decreased significantly during the observational period. No serious adverse effects were reported by any of the participants. CONCLUSIONS: Our observation suggests an inhibitory effect of GT and/or GTE on the progression of cardiac amyloidosis. We propose a randomized placebo-controlled investigation to confirm our observation

Staged cardiovascular magnetic resonance for differential diagnosis of Troponin T positive patients with low likelihood for acute coronary syndrome

<p>Abstract</p> <p>Background</p> <p>Cardiac Troponin-T (cTnT) is a cardio-specific indicator of myocardial necrosis due to ischemic or non-ischemic events. Considering the multiple causes of myocardial injury and treatment consequences there is great clinical need to clarify the underlying reason for cTnT release. We sought to implement acute CMR as a non-invasive imaging method for differential diagnosis of elevated cTnT in chest-pain unit (CPU) patients with non-conclusive symptoms and ECG-changes and a low to intermediate probability for coronary artery disease (CAD).</p> <p>Results</p> <p>CPU patients (n = 29) who had positive cTnT were scanned at 1.5T with a new step-by-step CMR algorithm including cine-, perfusion-, T2-, angiography-and late gadolinium enhancement (LGE) imaging. For comparison patients also underwent echocardiography and coronary angiography if necessary. CMR was conducted successfully in all patients and detected 93% of cTnT releases of unknown cause, without adverse hemodynamic or arrhythmic events. Acute myocardial infarction was detected in 11, pulmonary embolism in 6, myocarditis in 5, renal disease and cardiomyopathy in 2, storage disorder in 1 patient. In 2 patients CMR was unable to reveal the cause of cTnT elevations. Mean CMR scan-time was 35 ± 8 min. In 4 patients, CMR led to immediate coronary angiography with correct prediction of the infarct related artery.</p> <p>Conclusions</p> <p>We implemented a novel CMR algorithm to show the clinical value and practical feasibility of acute CMR in a non-conclusive patient cohort with unclear cTnT elevation. Since this pilot study has shown the feasibility of CMR in CPU patients, further prospective studies are warranted to compare CMR with other imaging modalities.</p

Les controverses sociotechniques au prisme du Parlement

Le Parlement constitue un espace privilégié pour analyser le déploiement des controverses sociotechniques : non parce qu’il aurait la faculté de les résoudre, notamment via l’OPECST, mais parce qu’il offre de multiples occasions et modalités d’expression et de traitement de ces controverses en son sein. Espace hétérogène et poreux, il participe d’une nouvelle gouvernance des risques, plus soucieuse de leur stabilisation que de leur réduction définitive.The French Parliament offers an ideal place to analyze the unfolding of sociotechnical controversies. Not that it has any capacity to actually resolve these, including its office of science and technology; but rather because it offers a plurality of opportunities for controversies to play out within its two chambers. As a heterogeneous and porous institution, it takes part in a newly formed risk governance that aims to manage rather than definitely solve risk issues