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

Better the devil you know:Threat effects and attachment to the European Union

The EU is facing unprecedented challenges and significant threats to its economic and political security. Austerity, the Eurozone crisis, rising immigration and heightened fear of terrorism all present serious challenges to the process of integration. How does this context of insecurity impact on what the EU means to its citizens? Will the public become increasingly Eurosceptic or will they discover a hitherto unrecognised attachment to the EU as the prospect of its collapse becomes real? Psychological research has demonstrated that individual exposure to threat decreases cognitive capacity, inducing a tendency towards rigidity or conservatism - a tendency to cling to the ‘devil you know’. So what might this mean for the European integration process? Using experimental techniques drawn from political psychology, the authors find a dual threat effect. The EU symbol has a negative (anti-EU) effect on EU-related attitudes when presented in neutral context. This is consonant with conceptualisations of the EU as a threat to national cultural and political norms. In contrast, however, visual priming of participants with EU symbols has a positive (pro-EU) effect on related attitudes when these are presented in a context that implies a subtle but imminent threat to the benefits of EU membership

Results of acoustic emission measurements in tensile tests on large specimens with notches

28.00; Translated from Czech. (Kovove Mater. 1989 v. 27(2) p. 240-252)Available from British Library Document Supply Centre- DSC:9023.19(VR-Trans--4453)T / BLDSC - British Library Document Supply CentreSIGLEGBUnited Kingdo

At the End of the Post-Communist Transformation? Normalization or Imagining Utopia?

This article reviews the implications of the collapse of Communism in Europe for some themes in recent social theory. It was often assumed that 1989 was part of a global process of normalization and routinization of social life that had been left behind earlier utopian hopes. Nothing that utopia is open to various interpretations, including utopias of the everyday, this article suggests, first that there were utopian dimensions to 1989, and, second, that these hopes continue to influence contemporary social and political developments. The continuing role of substantive utopian expectations is illustrated with reference to the politics of lustration in Poland and the rise of nationalist parties in Hungary. This analysis is placed in the context of the already apparent impact of the global economic crisis in post-communist countries. It concludes that the unevenness and diversity of the post-1989 world elude overly generalized attempts at theorization and demand more nuanced analyses

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