Status Update and Interim Results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2)

Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362. © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved

Democracy through the Lens of 1989: Liberal triumph or radical turn?

In a political reading, 1989 has been predominantly interpreted from a liberal point of view, and its impact has primarily been taken as strengthening the liberal-democratic idea of a political community. The year 1989 is, however, not reducible to a mere confirmation of a universal status of liberal democracy, rather, a reverse reading-i.e., the recognition of the emergence of innovative, radical democratic ideas and practices from the East-is equally important to do full justice to the complex events of 1989. As a set of ideas (more specifically, dissident thought) as well as a set of practices (negotiation, self-limitation, and constitution-making), 1989 has provided important inspiration for innovation in the normative political theory of democracy, even if on the margins. The essay starts with a brief enquiry into the widespread triumphalist thesis of liberal democracy and continues by arguing that a more radical reading of 1989-in particular in the form of the radical notions of civil society and dissidence-is equally possible. The notion of "self-democratizing civil society" offers important ways of preserving the radical legacy of East-Central European dissidence. The idea of self-democratizing civil society should, however, be read together with the ideas of radical self-limitation, an anti-revolutionary understanding of revolution, pluralistic sovereignty, and an ethic of dissent in order for one to fully appreciate its innovative potential for the radical reinvigoration of modern democracies. \ua9 2009 Springer Science+Business Media, LLC

VizieR Online Data Catalog: Mutual phenomena of Galilean satellites PHEMU03 (Arlot+, 2009)

VizieR Online Data Catalog. vol. 349.In 2003, the Sun and the Earth passed through both the equatorial plane of Jupiter and therefore the orbital planes of its main satellites. During this period, mutual eclipses and occultations were observed and we present the data collected. Light curves of mutual eclipses and occultations were recorded by the observers of the international campaign PHEMU03 organized by the Institut de Mecanique Celeste, Paris, France We completed 377 observations of 118 mutual events from 42 sites and the corresponding data are presented in this paper. For each observation, information about the telescope, receptor, site, and observational conditions are provided. This paper gathers all data and indicates a first estimate of its precision. This catalogue of these rare events should constitute an improved basis for accurate astrometric data useful in the development of dynamical models. (5 data files)