Outcomes in elderly patients undergoing endovascular thrombectomy in association with premorbid Rankin Scale scores

BackgroundEndovascular thrombectomy (EVT) reduces disability in patients with acute ischemic stroke (AIS); however, its efficacy in patients aged >80 years remains unclear.ObjectivesThis study aimed to assess the impact of premorbid modified Rankin Scale (pmRS) scores and age on patients with AIS undergoing EVT and the effect of EVT on functional outcome and mortality.MethodsWe conducted a retrospective cohort study and screened the Heidelberg Recanalization Registry (HeiReKa) database for patients with AIS between 1999 and 2021. Outcomes were stratified by age (<80, 80–89, and ≥90 years) and pmRS score (0–2 vs. 3–5). Adjusted odds ratios for outcomes and mortality at 3 months after treatment were examined.ResultsFinally, 2,591 patients were included [including those aged ≥90 years (n = 158)]. Poor functional outcomes were associated with advanced age, vascular risk factors, stroke severity, and vessel status. Conversely, lower prestroke disability and younger age were associated with better outcomes and reduced mortality. A pmRS of 3–5 was associated with an increased risk of mortality and worse functional outcomes regardless of age. Notably, patients aged ≥90 years with a pmRS of 0–2 had significantly better outcomes than those aged <80 years with a pmRS of 3–5.ConclusionBoth age and pmRS are important in assessing the benefits of EVT. However, prestroke functional status might be more crucial than biological age in determining outcomes following EVT

Applications and architectures in organic computing

This technical report documents a summary of the SPP-OC Workshop ”Architectures and Applications” at the University of Augsburg. Architectures and applications of organic computing systems are two of the profile topics of the priority program ”Organic Computing” of the German Research Foundation (DFG SPP 1183). The report contains the discussion results to the several questions discussed on the mentioned workshop.Dieser technische Bericht dokumentiert die Ergebnisse des SPP-OC Workshop "Architekturen und Anwendungen" an der Universität Augsburg. Architekturen und Anwendungen sind zwei Querschnittsthemen des Schwerpunktsprogramms der Universität Augsburg. Dieser Report dokumentiert die Ergebnisse dieses Workshops

Save the ‘Mittelstand’: How German Courts Protect Small and Medium-Sized Enterprises from Unfair Terms

Abstract: This article discusses the appropriateness of controlling standard terms in business-to-business (B2B) contracts. Using the example of Germany, where the Civil Code explicitly allows the control of B2B standard terms, it finds evidence that courts tend to use this control to favour small and medium-sized enterprises (the Mittelstand) in relation to bigger companies. This approach is questionable. It is suggested here that the rationale of standard terms control is not to compensate for power imbalances, which is the task of other legal institutions, such as competition law. Rather, the goal of such control should be to prevent and correct failing contractual and market mechanisms. It is further argued that clear criteria are required for assessing the fairness of standard terms in B2B relations, which are currently lacking both in German statutory provisions and in case law. Therefore, the article finds that it is not recommendable to emulate the German model on the European level. Before any clear criteria are found, the EU should not engage in the harmonization of B2B standard terms control. Resumé: Cet article s’interroge sur la pertinence du contrôle des conditions générales des contrats entre professionnels (B2B). En Allemagne, où le Code Civil étend explicitement le contrôle des conditions générales aux contrats B2B, on constate que les tribunaux ont tendance à utiliser ce contrôle pour privilégier les petites et moyennes entreprises (PME) par rapport aux grandes entreprises. Cette approche est discutable. Nous soutenons ici que les conditions générales n’ont pas vocation à compenser les déséquilibres dus aux positions dominantes sur le marché. Cela relève de la compétence d’autres institutions juridiques, comme par exemple du droit de la concurrence. L’objectif du contrôle des conditions générales devrait plutôt prévenir et corriger les défaillances des instruments de marchés ainsi que lesmécanismes de conclusions de contrats. A cet effet, il est nécessaire de fixer des critères clairs permettant de juger de la proportionnalité des clauses des conditions générales. Vu que ces dits critères font cependant défaut tant dans la législation que dans la jurisprudence, cet article recommande de ne pas s’inspirer du modèle allemand. Avant que tout critère clair se soit établi, l’UE ne devrait pas s’engager dans l’harmonisation du contrôle des conditions générales dans les contrats B2B.</jats:p