Nursing the fatherland? Hohenzollern statebuilding and the hidden transcript of political resistance in Hanoverian female charity during the Second German Empire

In summer 1866 the Austro-Prussian struggle for supremacy in Germany erupted into open conflict. King Georg V of Hanover sided with other governments loyal to the German Confederation against Prussia, but after initially defeating Prussian forces at Langensalza, he was forced to capitulate. Two days after the battle, on June 29, 1866, the widow of the Hanoverian general Sir Georg Julius von Hartmann told her daughter in no uncertain terms how she felt about the Prussian government and its allies. In her opinion they were nothing more than “robber states” that cloaked their disregard for the Ten Commandments in sanctimonious public displays of piety. “These Protestant Jesuits,” she continued, “offend me more than the Catholic ones. You know that I am German with all my heart and love my Germany, but I cannot consider them genuine Germans anymore because they only want to make Germany Prussian.”

Percutaneous aortic valve replacement for severe aortic stenosis in high-risk patients using the second- and current third-generation self-expanding CoreValve prosthesis: device success and 30-day clinical outcome

OBJECTIVES: We sought to determine both the procedural performance and safety of percutaneous implantation of the second (21-French [F])- and third (18-F)-generation CoreValve aortic valve prosthesis (CoreValve Inc., Irvine, California). BACKGROUND: Percutaneous aortic valve replacement represents an emerging alternative therapy for high-risk and inoperable patients with severe symptomatic aortic valve stenosis. METHODS: Patients with: 1) symptomatic, severe aortic valve stenosis (area <1 cm2); 2) age > or =80 years with a logistic EuroSCORE > or =20% (21-F group) or age > or =75 years with a logistic EuroSCORE > or =15% (18-F group); or 3) age > or =65 years plus additional prespecified risk factors were included. Introduction of the 18-F device enabled the transition from a multidisciplinary approach involving general anesthesia, surgical cut-down, and cardiopulmonary bypass to a truly percutaneous approach under local anesthesia without hemodynamic support. RESULTS: A total of 86 patients (21-F, n = 50; 18-F, n = 36) with a mean valve area of 0.66 +/- 0.19 cm2 (21-F) and 0.54 +/- 0.15 cm2 (18-F), a mean age of 81.3 +/- 5.2 years (21-F) and 83.4 +/- 6.7 years (18-F), and a mean logistic EuroSCORE of 23.4 +/- 13.5% (21-F) and 19.1 +/- 11.1% (18-F) were recruited. Acute device success was 88%. Successful device implantation resulted in a marked reduction of aortic transvalvular gradients (mean pre 43.7 mm Hg vs. post 9.0 mm Hg, p < 0.001) with aortic regurgitation grade remaining unchanged. Acute procedural success rate was 74% (21-F: 78%; 18-F: 69%). Procedural mortality was 6%. Overall 30-day mortality rate was 12%; the combined rate of death, stroke, and myocardial infarction was 22%. CONCLUSIONS: Treatment of severe aortic valve stenosis in high-risk patients with percutaneous implantation of the CoreValve prosthesis is feasible and associated with a lower mortality rate than predicted by risk algorithms.

[Localised rhabdomyosarcoma of the extremities in children and adolescents: results of the French experience]

PATIENTS AND METHODS: Forty-six patients with localised RMS of the limbs entered the MMT 89 and 95 study in France. We studied potential risk factors that were predictive of relapse and survival to propose a therapeutic approach of surgery and radiotherapy appropriate to the risk of relapse. RESULTS: Median age at diagnosis was 6.5 years [9 months to 15.5 years]. At time of diagnosis, 43% had marginal surgery and only 13% radical intervention. Primary re-excision was performed in 12% of the patients. All patients received chemotherapy, 43% had second look surgery and 37% received radiotherapy. Fifty-four percent of all tumors relapsed: local relapse 36%, nodes l8%, metastatic 40%, local and metastatic 16%. Estimated overall 5-year event-free survival (EFS) and overall survival (OS) were 40 and 57%, respectively. CONCLUSIONS: Prognosis of RMS of the limbs is bad but only 37% of the patients had radiotherapy. We could define patients with very high risk among those with limbs RMS as nodal involvement (5 years overall survival OS 22%), alveolar histology (OS 38%) and site of hand and foot (4 survivors out of 10 patients). In further studies, these patients should be treated even more aggressive with early surgery followed by re-excision if necessary, chemotherapy including alkylating agents and systematic radiotherapy.

Index-Oriented Methodologies for Landslide Consequence Analysis: An Application to a Mountain Community in the French Alps

Consequence analysis is a key aspect of anchoring assessment of landslide impacts to present and long-term development planning. Although several approaches have been developed over the last decade, some of them are difficult to apply in practice, mainly because of the lack of valuable data on historical damages or on damage functions. In this paper, two possible consequence indicators based on a combination of descriptors of the exposure of the elements at risk are proposed in order to map the potential impacts of landslides and highlight the most vulnerable areas. The first index maps the physical vulnerability due to landslide; the second index maps both direct damage (physical, structural, functional) and indirect damage (socio-economic impacts) of landslide hazards. The indexes have been computed for the 200 km2 area of the Barcelonnette Basin (South French Alps), and their potential applications are discussed.