305,732 research outputs found

    Atrocity Then, Trial Now: The Aesthetics, Acoustics, and Visualities of Prosecuting Oskar Gröning

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    This is the author accepted manuscript.Charged with aiding and abetting in the murder of three hundred thousand Hungarian Jews deported to Auschwitz between 16 May 1944 and 11 July 1944, Oskar Gröning, the ‘bookkeeper of Auschwitz’, was sentenced in 2015 by the Lüneburg Regional Court to four years’ imprisonment. After a series of unsuccessful appeals, Gröning died in 2018, at the age of 96, having never spent a day in jail. This contribution unpacks the charges against Gröning and his resultant conviction; examines the involvement of elderly victims as accusers and their roles in this trial; and, ultimately, contemplates how it all ‘looked’ and ‘sounded’. The focus is thus not only on Gröning himself, but on the totality of the trial of Gröning. Throughout, this contribution gazes upon the aesthetics, acoustics, and visualities of this trial and interrogates the representational credibility of dallied proceedings that occur seventy – increasingly, eighty – years after the fact. This chapter concludes by positing that however absurd it may seem to put a feeble old man on trial, the feebleness that oozes from not prosecuting such a man may prove even more absurd

    Oral anti-coagulants use in Chinese hospitalized patients with atrial fibrillation.

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    BackgroundOral anti-coagulants (OAC) are the intervention for the prevention of stroke, which consistently improve clinical outcomes and survival among patients with atrial fibrillation (AF). The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in China.MethodsUsing data from the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation (CCC-AF) registry, guideline-recommended OAC use in eligible patients was assessed.ResultsA total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019, of whom 38,203 were at a high risk of stroke, 9717 were at a moderate risk, and 4610 were at a low risk. On admission, only 20.0% (6075/30,420) of patients with a diagnosed AF and a high risk of stroke were taking OAC. The use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population (adjusted odds ratio: 0.54, 95% confidence interval: 0.43-0.68; P  ConclusionsIn hospitals participated in the CCC-AF project, >70% of AF patients were at a high risk of stroke. Although poor performance on guideline-recommended OAC use was found in this study, over time the CCC-AF project has made progress in stroke prevention in the Chinese AF population.Registration:ClinicalTrials.gov, NCT02309398

    Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

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    Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

    Crude mortality rates and adjusted hazard ratios (HRs) for the association of incident diabetes remission with all-cause and cause-specific mortality.

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    The HRs were adjusted for 1-year change (%) in weight, age at diabetes diagnosis, sex, assessment year, BMI, waist circumference, HbA1c, SBP, LDL-C, HDL-C, triglycerides, eGFR, smoking, alcohol drinking, oral glucose-lowering drugs, blood pressure–lowering drugs, lipid-lowering drugs, and diabetes duration. Squares represent HRs and lines represent 95% CIs. The area of each square is inversely proportional to the variance of log HR, which also determines the 95% CI. The axis for HR is natural log-transformed. Abbreviations: BMI, body mass index; CI, confidence interval; DBP, diastolic blood pressure; eGFR, estimated glomerular filtration rate; HR, hazard ratio; HbA1c, haemoglobin A1c; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein; SBP, systolic blood pressure.</p

    Compaction and clay content control mudrock porosity

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    Mudrocks, ubiquitous yet poorly understood sedimentary rocks with significant variations in composition and physical properties, form seals for geological carbon dioxide and energy (e.g., hydrogen and methane) storage, repositories for radioactive waste disposal, and reservoirs for natural gas. Understanding the controls on mudrock pore structure is essential for evaluating their porosity. The identification and quantification of controls depend on the nano-to micron scale pore network, which are the subject of this study. Small-angle (SANS) and very small-angle neutron scattering (VSANS) experiments were conducted on 13 diverse mudrock sets, characterised by differences in mineralogy, stratigraphy, maturity, and depositional environment. We performed multivariate statistics to systematically characterise the pore structure in 71 samples cross a 5 μm–2 nm pore size range. Our results indicate a multivariate approach more effectively captures the complex controls on porosity rather than single parameters. Compaction and clay content emerge as key primary and secondary controls on mudrock porosity, respectively, upon which we introduce a new porosity classification. Our complementary experimental-statistical assessment involving SANS-derived multiscale porosity sheds new light on the influence of structural controls on storage or production capacity in mudrocks