Beveridge on idleness

Beveridge's wartime proposals to eliminate idleness relied on the precepts of Keynesian economics and substantial extensions in the powers of central government to regulate industry and labour. Using convention theory, this paper demonstrates how these stipulations proved politically untenable. With the disappearance of full employment in the 1980s, the labour market problems Beveridge encountered in his youth have re-emerged accompanied by old problems of working poverty. Established forms of labour market analysis are obsolescent and employment rights disappear. The paper suggests a more decentralized and variable analysis of relations between work and idleness may offer a way forward

Predicting arrhythmia recurrence following catheter ablation for ventricular tachycardia using late gadolinium enhancement magnetic resonance imaging: Implications of varying scar ranges

Background: Thresholding-based analysis of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) can create scar maps and identify corridors that might provide a reentrant substrate for ventricular tachycardia (VT). Current recommendations use a full-width-at-half-maximum approach, effectively classifying areas with a pixel signal intensity (PSI) >40% as border zone (BZ) and >60% as core. Objective: The purpose of this study was to investigate the impact of 4 different threshold settings on scar and corridor quantification and to correlate this with postablation VT recurrence. Methods: Twenty-seven patients with ischemic cardiomyopathy who had undergone catheter ablation for VT were included for retrospective analysis. LGE-CMR images were analyzed using ADAS3D LV. Scar maps were created for 4 PSI thresholds (40–60, 35–65, 30–70, and 45–55), and the extent of variation in BZ and core, as well as the number and weight of conduction corridors, were quantified. Three-dimensional representations were reconstructed from exported segmentations and used to quantify the surface area between healthy myocardium and scar (BZ + core), and between BZ and core. Results: A wider PSI threshold was associated with an increase in BZ mass and decrease in scar (P <.001). No significant differences were observed for the total number of corridors and their mass with increasing PSI threshold. The best correlation in predicting arrhythmia recurrence was observed for PSI 45–55 (area under the curve 0.807; P =.001). Conclusion: Varying PSI has a significant impact on quantification of LGE-CMR parameters and may have incremental clinical value in predicting arrhythmia recurrence. Further prospective investigation is warranted to clarify the functional implications of these findings for LGE-CMR–guided ventricular ablation

Double-kissing culotte technique for coronary bifurcation stenting

Aims: The aim of this study was to assess whether the culotte technique could be improved by an additional kissing dilation prior to main branch (MB) stenting. Methods and results: Double-kissing (DK) culotte was compared to the culotte and DK-crush techniques in a bench model (n=24). Results were evaluated for stent apposition, luminal opening and flow dynamics. The total procedure duration of DK-culotte was 18.3±3.4 minutes, significantly lower than for DK-crush (24.3±5.7 min; p=0.015), but similar to culotte (21.6±5.9 min, p=0.104). In DK-culotte the overall rate of moderate (200-500 μm) and significant (>500 μm) malapposition was 2.1±1.9% and 0.4±0.2%, similar as compared to culotte (3.7±3.8%, p=0.459 and 1.0±1.0%, p=0.517, respectively), and lower as compared to DK-crush (8.1±2.5%, p<0.001 and 3.7±5.3%, p=0.002, respectively). The lower malapposition rate of DK-culotte as compared to DK-crush was due to less moderate and significant malapposition in the proximal MB (0.0±0.0% vs 14.0±7.6%, p<0.001 and 0.0±0.0% vs 4.2±9.1%, p=0.026, respectively). Micro-computed tomography did not show a difference in luminal opening at the proximal MB, distal MB or SB. There was no difference either in the maximum shear rate or in areas of high shear or recirculation. Conclusions: Bench test data suggest that the DK approach facilitates the culotte technique. The clinical validity and relevance remain to be confirmed in a larger in vivo population