623 resultados para Tiekso, Tanja
Resumo:
Der moderne Nationalstaat mit seinen Grenzlinien, welche die räumliche Reichweite des souveränen Gewaltmonopols fixierten und gleichsam einen Kulturraum mit homogenen sozialen und rechtlichen Normen abschlossen, war lange eine zentrale Orientierungsgröße für die Geschichtsschreibung. Die wirtschaftlichen, politischen und kulturellen Globalisierungsprozesse der letzten zwei Jahrzehnte haben jedoch das nationale Narrativ mit seinen eindeutigen Demarkationslinien in Frage gestellt. Stattdessen sind Randzonen und Zwischenräume in den Mittelpunkt des Interesses gerückt. Dieser Paradigmenwechsel in Methodik und Perspektive hat auch realhistorisch seine volle Berechtigung, denn solche Zwischenräume sind keine neuartigen Phänomene der Postmoderne mit ihren globalen Transfers und multikulturellen Gesellschaften. Sie hatten sich beispielsweise stets auch während des Epochen übergreifenden Prozesses der europäischen Expansion aufgetan, insbesondere an den fluiden imperialen Randzonen. Nach eurozentrischen Maßstäben handelte es sich dabei um rechtlich nicht regulierte und territorial undefinierte Räume. Aber selbst in der Hochphase des Imperialismus sowie auch in den postkolonialen Gesellschaften konnte das nationalstaatliche Modell nur partiell etabliert werden und konkurrierte stets mit „tribalen“ oder quasi-feudalen Formen sozio-politischer Organisation. Außerdem wurde selbst in den westlichen Nationalstaaten das staatliche Gewaltmonopol sowie die soziale, rechtliche und politische Ordnung bei innerstaatlichen Konflikten wie Revolutionen und Bürgerkriegen sowie internationalen Kriegen immer wieder in Frage gestellt oder sogar ausgehebelt. In solch gewaltbasierten Umfeldern des Ausnahmezustandes und der Insurrektion sowie in solch deregulierten Räumen, weitgehend frei von Hierarchien, bürokratischer Kontrolle und rechtlichen Einschränkungen, agierten stets auch besondere Akteurstypen. Sie hatten einerseits das Privileg einer geringen Kontrolle unterworfen zu sein oder völlig losgelöst davon zu handeln, waren aber andererseits überwiegend auf sich gestellt und konnten nur sehr beschränkt den Schutz des fernen Souveräns im Hintergrund beanspruchen oder hatten sich diesen durch ihre Verhaltensweise sogar zum Gegner gemacht. Diese Akteure an den Randzonen von Souveränität und Legitimität können grob in verschiedene Typen eingeteilt werden: Zu nennen sind die Avantgardisten der Expansion wie Entdecker und Eroberer, die klassischen „Men on the Spot“ an der Peripherie von Imperien wie Militärs und Administratoren, private Gewaltunternehmer und Söldner, Insurgenten und Revolutionäre, sowie Spione und Nachrichtenhändler. Anhand verschiedener Fallstudien soll diese Figur des Akteurs an den Randzonen in globaler Perspektive beleuchtet werden. Es stellt sich die Frage nach seiner Motivation für Sondermissionen, seiner ideellen Beweggründe und politischen Überzeugung sowie seiner Beziehung zum Auftraggeber oder Souverän im fernen Hintergrund. Insbesondere ist untersuchen, ob deren Interessen trotz beschränkter Kontrolle und Rückendeckung loyal verfolgt wurden oder ob für unsere Protagonisten vor allem materielle Interessen ausschlaggebend waren, womöglich sogar einfach das Streben nach einem Betätigungsfeld mit möglichst großer Handlungsfreiheit? Während entgrenzte Verhaltensweisen in der Regel auf rechtlich nur schwach regulierte Umfeldern zurückgeführt werden, ist auch zu untersuchen, ob sich gewisse Persönlichkeiten nicht gezielt Räume am Rande oder jenseits nationalstaatlicher Rechtsnormen als Agitationsfeld suchten oder ob sie sich sogar zur Verwirklichung ihrer persönlichen Bedürfnisse solche Räume durch Subversion staatlicher Ordnung gezielt schafften. Indem die Protagonisten mit den kulturellen, politischen und rechtlichen Ordnungen ihres Betätigungsfeldes in Beziehung gesetzt werden, kann auch eine Brücke von einer rein personenbezogenen Biographik zur Strukturgeschichte geschlagen werden. Die Grenzgänger wie auch die Zwischenräume, in denen sie agierten, sind wohl auch weniger als Randerscheinungen des Ausnahmezustandes zu verstehen, sondern vielmehr als die unmittelbar mit der sich intensivierenden Verrechtlichung und Homogenisierung der westeuropäischen Nationalstaaten einhergehende andere Seite dieses Prozesses: Einerseits brauchten Regierungen zuweilen für besondere Aufgaben Akteure, die nicht an die eigenen Rechtsnormen gebunden waren, andererseits gab es stets Persönlichkeiten, die sich in der engen Rechtswirklichkeit und sozialen Ordnung des Nationalstaates nicht zurechtfanden. Darüber hinaus sind diese Grenzgänger auch als Brückenköpfe politischer wie ökonomischer Machterweiterung sowie als Schlüsselfiguren von Interaktions-, Kooperations-, Vernetzungs- und Transformationsprozessen zu verstehen – nur in Extremfällen waren sie radikale Grenzüberschreiter sowie Träger der bloßen Zerstörung und Zersetzung. Da sie in einem kulturell fremden oder zerrütteten, krisengebeutelten Umfeld agierten, gilt ein besonderes Augenmerk ihrer Rolle als Makler von Interessen, Vermittler sowie Informationsbeschaffer. Schließlich soll auch die Außenwahrnehmung dieser Randfiguren in Betracht gezogen werden. Ihre Position am Rande der Gesellschaft und der Legalität löste in der Regel eine große Faszination beim „Normalbürger“ aus, die sich entweder in Bewunderung oder Abscheu wenden konnte. Teilweise veranlassten sie einen regelrechten Medienrummel, der den Staat wiederum in Zugzwang bringen konnte, oft mit beachtlichen Folgen.
Resumo:
AIMS The genetic polymorphism of apolipoprotein E (APOE) has been suggested to modify the effect of smoking on the development of coronary artery disease (CAD) in apparently healthy persons. The interaction of these factors in persons undergoing coronary angiography is not known. METHODS AND RESULTS We analysed the association between the APOE-genotype, smoking, angiographic CAD, and mortality in 3263 participants of the LUdwigshafen RIsk and Cardiovascular Health study. APOE-genotypes were associated with CAD [ε22 or ε23: odds ratio (OR) 0.56, 95% confidence interval (CI) 0.43-0.71; ε24 or ε34 or ε44: OR 1.10, 95% CI 0.89-1.37 compared with ε33] and moderately with cardiovascular mortality [ε22 or ε23: hazard ratio (HR) 0.71, 95% CI 0.51-0.99; ε33: HR 0.92, 95% CI 0.75-1.14 compared with ε24 or ε34 or ε44]. HRs for total mortality were 1.39 (95% CI 0.39-0.1.67), 2.29 (95% CI 1.85-2.83), 2.07 (95% CI 1.64-2.62), and 2.95 (95% CI 2.10-4.17) in ex-smokers, current smokers, current smokers without, or current smokers with one ε4 allele, respectively, compared with never-smokers. Carrying ε4 increased mortality in current, but not in ex-smokers (HR 1.66, 95% CI 1.04-2.64 for interaction). These findings applied to cardiovascular mortality, were robust against adjustment for cardiovascular risk factors, and consistent across subgroups. No interaction of smoking and ε4 was seen regarding non-cardiovascular mortality. Smokers with ε4 had reduced average low-density lipoprotein (LDL) diameters, elevated oxidized LDL, and lipoprotein-associated phospholipase A2. CONCLUSION In persons undergoing coronary angiography, there is a significant interaction between APOE-genotype and smoking. The presence of the ε4 allele in current smokers increases cardiovascular and all-cause mortality.
Resumo:
BACKGROUND Conventional factors do not fully explain the distribution of cardiovascular outcomes. Biomarkers are known to participate in well-established pathways associated with cardiovascular disease, and may therefore provide further information over and above conventional risk factors. This study sought to determine whether individual and/or combined assessment of 9 biomarkers improved discrimination, calibration and reclassification of cardiovascular mortality. METHODS 3267 patients (2283 men), aged 18-95 years, at intermediate-to-high-risk of cardiovascular disease were followed in this prospective cohort study. Conventional risk factors and biomarkers were included based on forward and backward Cox proportional stepwise selection models. RESULTS During 10-years of follow-up, 546 fatal cardiovascular events occurred. Four biomarkers (interleukin-6, neutrophils, von Willebrand factor, and 25-hydroxyvitamin D) were retained during stepwise selection procedures for subsequent analyses. Simultaneous inclusion of these biomarkers significantly improved discrimination as measured by the C-index (0.78, P = 0.0001), and integrated discrimination improvement (0.0219, P<0.0001). Collectively, these biomarkers improved net reclassification for cardiovascular death by 10.6% (P<0.0001) when added to the conventional risk model. CONCLUSIONS In terms of adverse cardiovascular prognosis, a biomarker panel consisting of interleukin-6, neutrophils, von Willebrand factor, and 25-hydroxyvitamin D offered significant incremental value beyond that conveyed by simple conventional risk factors.
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AIMS Cystatin C is a well established marker of kidney function. There is evidence that cystatin C concentrations are also associated with mortality. The present analysis prospectively evaluated the associations of cystatin C with all-cause and cardiovascular (CV) mortality in a well-characterized cohort of persons undergoing angiography, but without overt renal insufficiency. METHODS Cystatin C was available in 2998 persons (mean age: 62.7 ± 10.5 years; 30.3% women). Of those 2346 suffered from coronary artery disease (CAD) and 652 (controls) did not. Creatinine (mean ± SD: 83.1 ± 47.8 vs. 74.1 ± 24.7 μmol/L, p = 0.036) but not Cystatin C (mean ± SD: 1.02 ± 0.44 vs. 0.92 ± 0.26 mg/L, p = 0.065) was significantly higher in patients with CAD. After a median follow-up of 9.9 years, in total 898 (30%) deaths occurred, 554 (18.5%) due to CV disease and 326 (10.9%) due to non-CV causes. Multivariable-adjusted Cox analysis (adjusting for eGFR and established cardiovascular risk factors, lipid lowering therapy, angiographic coronary artery disease, and C-reactive protein) revealed that patients in the highest cystatin C quartile were at an increased risk for all-cause (hazard ratio (HR) 1.93, 95% CI 1.50-2.48) and CV mortality (HR 2.05 95% CI 1.48-2.84) compared to those in the lowest quartile. The addition of cystatin C to a model consisting of established cardiovascular risk factors increased the area under the receiver-operating characteristic curve for CV and all-cause mortality, but the difference was statistically not significant. However, reclassification analysis revealed significant improvement by addition of cystatin C for CV and all-cause mortality (p < 0.001), respectively. CONCLUSION The concentration of cystatin C is strongly associated with long-term all-cause and cardiovascular mortality in patients referred to coronary angiography, irrespective of creatinine-based renal function.
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OBJECTIVES This study sought to determine whether high intestinal cholesterol absorption represents a cardiovascular risk factor and to link ABCG8 and ABO variants to cardiovascular disease (CVD). BACKGROUND Plant sterol-enriched functional foods are widely used for cholesterol lowering. Their regular intake yields a 2-fold increase in circulating plant sterol levels that equally represent markers of cholesterol absorption. Variants in ABCG8 and ABO have been associated with circulating plant sterol levels and CVD, thereby suggesting atherogenic effects of plant sterols or of cholesterol uptake. METHODS The cholestanol-to-cholesterol ratio (CR) was used as an estimate of cholesterol absorption because it is independent of plant sterols. First, we investigated the associations of 6 single nucleotide polymorphisms in ABCG8 and ABO with CR in the LURIC (LUdwisghafen RIsk and Cardiovascular health study) and the YFS (Young Finns Study) cohorts. Second, we conducted a systematic review and meta-analysis to investigate whether CR might be related to CVD. RESULTS In LURIC, the minor alleles of rs4245791 and rs4299376 and the major alleles of rs41360247, rs6576629, and rs4953023 of the ABCG8 gene and the minor allele of rs657152 of the ABO gene were significantly associated with higher CR. Consistent results were obtained for rs4245791, rs4299376, rs6576629, and rs4953023 in YFS. The meta-analysis, including 6 studies and 4,362 individuals, found that CR was significantly increased in individuals with CVD. CONCLUSIONS High cholesterol absorption is associated with risk alleles in ABCG8 and ABO and with CVD. Harm caused by elevated cholesterol absorption rather than by plant sterols may therefore mediate the relationships of ABCG8 and ABO variants with CVD.
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AIMS High-density lipoprotein (HDL) cholesterol is a strong predictor of cardiovascular mortality. This work aimed to investigate whether the presence of coronary artery disease (CAD) impacts on its predictive value. METHODS AND RESULTS We studied 3141 participants (2191 males, 950 females) of the LUdwigshafen RIsk and Cardiovascular health (LURIC) study. They had a mean ± standard deviation age of 62.6 ± 10.6 years, body mass index of 27.5 ± 4.1 kg/m², and HDL cholesterol of 38.9 ± 10.8 mg/dL. The cohort consisted of 699 people without CAD, 1515 patients with stable CAD, and 927 patients with unstable CAD. The participants were prospectively followed for cardiovascular mortality over a median (inter-quartile range) period of 9.9 (8.7-10.7) years. A total of 590 participants died from cardiovascular diseases. High-density lipoprotein cholesterol by tertiles was inversely related to cardiovascular mortality in the entire cohort (P = 0.009). There was significant interaction between HDL cholesterol and CAD in predicting the outcome (P = 0.007). In stratified analyses, HDL cholesterol was strongly associated with cardiovascular mortality in people without CAD [3rd vs. 1st tertile: HR (95% CI) = 0.37 (0.18-0.74), P = 0.005], but not in patients with stable [3rd vs. 1st tertile: HR (95% CI) = 0.81 (0.61-1.09), P = 0.159] and unstable [3rd vs. 1st tertile: HR (95% CI) = 0.91 (0.59-1.41), P = 0.675] CAD. These results were replicated by analyses in 3413 participants of the AtheroGene cohort and 5738 participants of the ESTHER cohort, and by a meta-analysis comprising all three cohorts. CONCLUSION The inverse relationship of HDL cholesterol with cardiovascular mortality is weakened in patients with CAD. The usefulness of considering HDL cholesterol for cardiovascular risk stratification seems limited in such patients.
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AIMS The purpose of this study was to identify novel genetic variants influencing circulating asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) levels and to evaluate whether they have a prognostic value on cardiovascular mortality. METHODS AND RESULTS We conducted a genome-wide association study on the methylarginine traits and investigated the predictive value of the new discovered variants on mortality. Our meta-analyses replicated the previously known locus for ADMA levels in DDAH1 (rs997251; P = 1.4 × 10(-40)), identified two non-synomyous polymorphisms for SDMA levels in AGXT2 (rs37369; P = 1.4 × 10(-40) and rs16899974; P = 1.5 × 10(-38)) and one in SLC25A45 (rs34400381; P = 2.5 × 10(-10)). We also fine-mapped the AGXT2 locus for further independent association signals. The two non-synonymous AGXT2 variants independently associated with SDMA levels were also significantly related with short-term heart rate variability (HRV) indices in young adults. The major allele (C) of the novel non-synonymous rs16899974 (V498L) variant associated with decreased SDMA levels and an increase in the ratio between the low- and high-frequency spectral components of HRV (P = 0.00047). Furthermore, the SDMA decreasing allele (G) of the non-synomyous SLC25A45 (R285C) variant was associated with a lower resting mean heart rate during the HRV measurements (P = 0.0046), but not with the HRV indices. None of the studied genome-wide significant variants had any major effect on cardiovascular or total mortality in patients referred for coronary angiography. CONCLUSIONS AGXT2 has an important role in SDMA metabolism in humans. AGXT2 may additionally have an unanticipated role in the autonomic nervous system regulation of cardiac function.
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When the German government faced for the first time an irregular war in German East Africa in 1888, it realised that it did not have the necessary means for such a conflict. Hermann Wissmann, an explorer, was therefore given the mandate to form and lead a force of mercenaries that was bound to him personally on the basis of contracts. Although Wissmann was successful in crushing the disturbances, the government of the Reich refused to give him a leading administrative position in the new formed protectorate subordinate directly to the Kaiser. It feared that the entrepreneur of violence, which had up to then been backed up, would not accept the regulations of colonial rule that should be implemented. Soon, however, it became clear that due to entrenched local views on sovereignty and legitimacy it would be difficult to transfer the western European concept of the monopoly of the state on violence to Africa.