Réduction des artéfacts de tuteur coronarien au moyen d’un algorithme de reconstruction avec renforcement des bords : étude prospective transversale en tomodensitométrie 256 coupes

Les artéfacts métalliques entraînent un épaississement artéfactuel de la paroi des tuteurs en tomodensitométrie (TDM) avec réduction apparente de leur lumière. Cette étude transversale prospective, devis mesures répétées et observateurs avec méthode en aveugle, chez 24 patients consécutifs/71 tuteurs coronariens a pour objectif de comparer l’épaisseur de paroi des tuteurs en TDM après reconstruction par un algorithme avec renforcement des bords et un algorithme standard. Une angiographie coronarienne par TDM 256 coupes a été réalisée, avec reconstruction par algorithmes avec renforcement des bords et standard. L’épaisseur de paroi des tuteurs était mesurée par méthodes orthogonale (diamètres) et circonférentielle (circonférences). La qualité d’image des tuteurs était évaluée par échelle ordinale, et les données analysées par modèles linéaire mixte et régression logistique des cotes proportionnelles. L’épaisseur de paroi des tuteurs était inférieure avec l’algorithme avec renforcement des bords comparé à l’algorithme standard, avec les méthodes orthogonale (0,97±0,02 vs 1,09±0,03 mm, respectivement; p<0,001) et circonférentielle (1,13±0,02 vs 1,21±0,02 mm, respectivement; p<0,001). Le premier causait moins de surestimation par rapport à l’épaisseur nominale comparé au second, avec méthodes orthogonale (0,89±0,19 vs 1,00±0,26 mm, respectivement; p<0,001) et circonférentielle (1,06±0,26 vs 1,13±0,31 mm, respectivement; p=0,005) et diminuait de 6 % la surestimation. Les scores de qualité étaient meilleurs avec l’algorithme avec renforcement des bords (OR 3,71; IC 95% 2,33–5,92; p<0,001). En conclusion, la reconstruction des images avec l’algorithme avec renforcement des bords génère des parois de tuteurs plus minces, moins de surestimation, et de meilleurs scores de qualité d’image que l’algorithme standard.

The EU’s comprehensive approach towards security: the Lisbon Treaty and “smart power”. EU Centre Singpore Policy Brief No. 6, May 2013

The European Union (EU) has increasingly become a comprehensive security actor. With the development of the Common Foreign and Security Policy (CFSP), including the Common Security and Defence Policy (CSDP) as a reaction to the failure of the EU to act during the wars in Yugoslavia/Western Balkans in the 1990s, the EU has a wide range of instruments for crisis prevention, crisis management as well as post-crisis intervention at its disposal. Observers typically agree that “hard power” is no longer sufficient to address the complex security challenges of today’s world while the EU, often criticised for only utilising “soft power”, is now able to exercise “smart power”. Through a comprehensive approach, facilitated by the Lisbon Treaty, the EU can now use the various instruments at its disposal, such as diplomacy, development aid, humanitarian assistance, trade, sanctions, international cooperation and crisis management capabilities in a joined-up manner. This mix of tools and instruments is helping the EU to achieve the aim set out in its European Security Strategy: “a secure Europe in a better world”.

Labour Market Reforms and Current Account Imbalances: Beggar-thy-neighbour policies in a currency union? CEPS Working Document No. 399/September 2014

Member countries of the Economic and Monetary Union (EMU) initiated wide-ranging labour market reforms in the last decade. This process is ongoing as countries that are faced with serious labour market imbalances perceive reforms as the fastest way to restore competitiveness within a currency union. This fosters fears among observers about a beggar-thy-neighbour policy that leaves non-reforming countries with a loss in competitiveness and an increase in foreign debt. Using a two-country, two-sector search and matching DSGE model, we analyse the impact of labour market reforms on the transmission of macroeconomic shocks in both non-reforming and reforming countries. By analysing the impact of reforms on foreign debt, we contribute to the debate on whether labour market reforms increase or reduce current account imbalances.

Turkey votes: Part III - President Erdoğan - A foregone conclusion? EPC Commentary, 10 July 2014

On 1 July, after months of speculation, Turkey’s Prime Minister, Recep Tayyip Erdoğan, announced he would run in the country’s first direct presidential elections on 10 August. Erdoğan, who has dominated Turkish politics for over a decade, is viewed as the clear favourite. With current polls suggesting he could take as much as 52% of the vote, an outright victory in the first round is possible. His main rival, Ekmeleddin İhsanoğlu, is very much the underdog. Until recently, an international diplomat with no experience in politics, he is the joint candidate of Turkey’s two main opposition parties, the Republican People’s Party (CHP) and the Nationalist Movement Party (MHP). Selahattin Demirtaş, the Co-Chairman of the Kurdish Peoples Democratic Party (HDP) is also in the race, but is not expected to make it into double digits. The Kurdish vote however, could prove to be crucial if the ballot goes to a second round on 24 August. With Erdoğan wanting to increase Presidential powers, the stakes are high. With his belief in majoritarian rule, and increasingly authoritarian style of governance there has been an erosion of democracy and civil liberties. Many observers fear this trend may increase.

The Kyrgyzstani Presidential Elections: Atambaev’s Challenges. EUCAM Commentary No. 21, November 2011

After much anticipation and anxiety about the presidential elections in Kyrgyzstan, there is a feeling of relief that Almazbek Atambaev won the contest with an overwhelming majority, making a second round of elections unnecessary. The presidential race passed off without violence and unrest, which many in Kyrgyzstan consider an achievement in itself. The scale of Atambaev’s majority took many commentators by surprise as some had predicted a low turnout and a strong oppositional challenge. But according to the Central Electoral Commission, the turnout was 61.28 percent and Atambaev gained 63 percent of the votes. The elections were observed by 792 international observers from 56 countries. Although international observers have criticized electoral irregularities, pointing to incomplete voter registrations and ballot stuffing, overall the elections were assessed as encouraging.

The Path to European Integration: A Historical Institutionalist Perspective, CES Germany & Europe Working Papers, No. 05.2, 25 October 1994

Many European and American observers of the EC have criticized "intergovemmentalist" ac­ counts for exaggerating the extent of member state control over the process of European integra­ tion. This essay seeks to ground these criticisms in a "historical institutionalist" account that stresses the need to study European integration as a political process which unfolds over time. Such a perspective highlights the limits of member-state control over long-term institutional de­ velopment, due to preoccupation with shorHerm concerns, the ubiquity of unintended conse­ quences, and processes that "lock in" past decusions and make reassertions of member-state control difficult. Brief examination of the evolution of social policy in the EC suggests the limita­ tions of treating the EC as an international regime facilitating collective action among essentially sovereign states. It is ore useful to view integration as a "path-dependent" process that has pro­ duced a fragmented but still discernible "multitiered" European polity.

A House Divided: Employers & the Challenge to Pattern Bargaining in a United Germany. CES Germany & Europe Working Papers, No. 05.5, 1994

Recently, increasing numbers of new German firms have begun to break from tradition and refuse to join employers' associations. Simultaneously, an unprecedented portion of affiliates have begun to reconsider employers' association membership. The spectre of declining membership in German employers' associations-century-old pillars of organized capitalism-is particularly noteworthy because of the importance of these institutions to the German economy as a whole. Some observers have attributed this trend to the impact of German unification, yet a careful analysis reveals that its principal causes arose in the decade preceding it. The economic strain of unification, however, has accelerated "association flight'' and has provided dissidents with an unprecedented opportunity to challenge the hegemony of employers' associations over the regulation of wages and working conditions in the Federal Republic.

Structure as Process: The Regularized Intergovernmentalism of Franco-German Bilateralism, CES Germany & Europe Working Papers, No.02.3, 2002

This article systematically scrutinizes the intergovernmental and administrative aspects of Franco- German relations with the 1963 Elysée Treaty at their core. This treaty, together with its various additions and extensions, has defined the basic processes of bilateral interaction between the French and German states. Recurrent tension in Franco-German relations notwithstanding, many observers and participants have viewed France and Germany to be connected particularly closely since the 1960s. This article explores key elements of what it is that links France and Germany. Thereby it clarifies the concept of regularized intergovernmentalism, suggests viewing this specific set of international practices from a social-structural perspective, and evaluates the effects and limits of such regularized procedures. Its findings suggest that bilateral structures have complemented and undergirded a broadly multilateral post-World War II world and are likely to continue to do.

The Energy Performance of Buildings: Promises Still Unfulfilled. Egmont Paper No. 78, May 2015

EXECUTIVE SUMMARY All observers agree that energy efficiency must be the cornerstone of any serious EU energy strategy. In this general context, the EU building sector is critical. It represents about 40% of EU final energy consumption (residential houses, public/private offices, commercial buildings, etc.) and approximately 36% of EU CO2 emissions. This is massive. The EU has certainly not been inactive in this field. The Energy Performance in Buildings Directive 2002/91/EC (EPBD) was the first and the main instrument to address the problem of the energy performance of buildings. It has established numerous principles: a reliable methodology which enables the calculation and rating of the energy performance of buildings; minimum energy performance standards for new buildings and existing buildings under major renovation; energy performance certificates; regular inspection of heating and air-conditioning systems; and, finally, quality standards for inspections and energy performance certificates. They were strengthened in 2010 by the recast Directive 2010/31/EU. This directive also introduces a decisive concept for the development of the building sector: ‘nearly zeroenergy buildings’. In 2012, the new Energy Efficiency Directive 2012/27/EU dealt with other aspects. In the building sector, three of them are particularly important. They concern: (1) the establishment of long-term strategies for mobilizing investment in the renovation of the national building stocks; (2) the introduction of energy saving schemes for ‘designated’ energy companies with a view to reducing consumption among ‘final consumers’ by 1.5% annually; and (3), as an option, the setting up of an Energy Efficiency National Fund to support energy efficiency initiatives. This paper also briefly examines the different instruments put in place to disseminate information and consultation, and the EU funding for energy efficiency in buildings. Results, however, have remained limited until now. The improvement of the energy performance of buildings and the rhythm of renovation remain extremely weak. Member States’ unwillingness to timely and properly transpose and implement the Directives continues despite the high degree of flexibility permitted. The decentralized approach chosen for some specific aspects and the differentiation in the application of EPBD standards between Member States do not appear optimal either. Adequate financial schemes remain rare. The permanent deficit of qualified and trained personnel and the inertia of public authorities to make the public understand the stakes in this domain remain problematic. Hence the need to take new initiatives to reap the benefits that the building sector is meant to bring.

The Greek elections and the third bailout programme: Why it could work this time round. CEPS Commentary, 21 September 2015

Following the decisive victory won by the Syriza party in Greece’s general election on September 20th, this commentary explores the key question of whether the third bailout programme can work, where the previous two programmes failed. Whereas most observers argue that the third one cannot work because it merely represents a continuation of an approach that has manifestly failed, the authors argue that a closer inspection of the conditions today give grounds for cautious optimism.

Going Global, Going West! Chinese Direct Investment in Germany. Asia Policy Brief 2014/03, May 2014

Chinese investors are welcome! Germany’s Federal Minister of Economy, Sigmar Gabriel, made this clear at the opening ceremony of the Chinese Chamber of Commerce in Berlin in January 2014. His words were not only meant as an invitation to Chinese companies, but also as a piece of advice for Germany’s business community and broader public. Chinese investors are often perceived to be going on a “global shopping spree” with a “political checkbook”, not only in Germany but everywhere in Europe. Some observers even suggest stricter controls for investors from specific countries, such as China. The German government is right to pursue the principle of a free trade and investment regime, while insisting that China’s government should level the playing field for foreign companies, too.

How can we enhance our security without damaging our liberty? For a Progressive and European Rehabilitation of Sovereignty. European Policy Brief No. 41, January 2016

How can we reinforce internal security without destroying basic freedoms? This dilemma will become increasingly topical in the context of rising terrorist threats and in view of some of the responses already put in place at the national level. Many observers have pointed out the threat that these measures pose to individual freedom. But few have highlighted their relative inefficiency. Indeed, if the right to security is one of the founding reasons for political government and one of its main sources of legitimacy, can states still guarantee this basic right? This article examines this dilemma and focuses more specifically on its implications for the notion and practice of sovereignty. It also sketches a strong, but nuanced, rescue of sovereignty at the European level in order to assure individual security while, at the same time, protecting our freedoms.

Construção e validação de um sistema de observação em competição no futebol de bolas paradas

Tendo em conta a importância assumida das bolas paradas (BP), como elementos decisivos no desenvolvimento e decisão nos jogos de futebol, o objetivo do estudo foi construir e validar um Sistema de Observação em Competição no Futebol de Bolas Paradas (SOCFutBP), de acordo com a metodologia observacional e suportado por um software de análise de jogo (VideObserver). O estudo foi constituído por uma amostra de 80 ações de bolas paradas observadas numa das partes de um jogo de futebol do Campeonato Nacional de Juvenis de Sub-17. A metodologia de desenvolvimento do sistema de observação adotou os seguintes passos: definição de critérios (e respetivas categorias); seleção e adequação do instrumento; aperfeiçoamento e validação facial do sistema; validação propriamente dita do sistema (intra e inter-observadores) e aplicação do estudo piloto. O Sistema de Observação em Competição de Futebol de Bola Paradas (SOCFutBP) foi construído e validado apresentando dez critérios adequados e ajustados para a recolha e análise de dados no âmbito da investigação focada nas bolas paradas no Futebol, uma vez que todos os critérios apresentaram valores de K superiores a 0,75 na fiabilidade intra-observador e inter-observadores.

Use of Extended Characteristics of Locomotion and Feeding Behavior for Automated Identification of Lame Dairy Cows.

This study was carried out to detect differences in locomotion and feeding behavior in lame (group L; n = 41; gait score ≥ 2.5) and non-lame (group C; n = 12; gait score ≤ 2) multiparous Holstein cows in a cross-sectional study design. A model for automatic lameness detection was created, using data from accelerometers attached to the hind limbs and noseband sensors attached to the head. Each cow's gait was videotaped and scored on a 5-point scale before and after a period of 3 consecutive days of behavioral data recording. The mean value of 3 independent experienced observers was taken as a definite gait score and considered to be the gold standard. For statistical analysis, data from the noseband sensor and one of two accelerometers per cow (randomly selected) of 2 out of 3 randomly selected days was used. For comparison between group L and group C, the T-test, the Aspin-Welch Test and the Wilcoxon Test were used. The sensitivity and specificity for lameness detection was determined with logistic regression and ROC-analysis. Group L compared to group C had significantly lower eating and ruminating time, fewer eating chews, ruminating chews and ruminating boluses, longer lying time and lying bout duration, lower standing time, fewer standing and walking bouts, fewer, slower and shorter strides and a lower walking speed. The model considering the number of standing bouts and walking speed was the best predictor of cows being lame with a sensitivity of 90.2% and specificity of 91.7%. Sensitivity and specificity of the lameness detection model were considered to be very high, even without the use of halter data. It was concluded that under the conditions of the study farm, accelerometer data were suitable for accurately distinguishing between lame and non-lame dairy cows, even in cases of slight lameness with a gait score of 2.5.

Electrocardiographic features of disease progression in arrhythmogenic right ventricular cardiomyopathy/dysplasia.

BACKGROUND Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is considered a progressive cardiomyopathy. However, data on the clinical features of disease progression are limited. The aim of this study was to assess 12-lead surface electrocardiographic (ECG) changes during long-term follow-up, and to compare these findings with echocardiographic data in our large cohort of patients with ARVC/D. METHODS Baseline and follow-up ECGs of 111 patients from three tertiary care centers in Switzerland were systematically analyzed with digital calipers by two blinded observers, and correlated with findings from transthoracic echocardiography. RESULTS The median follow-up was 4 years (IQR 1.9-9.2 years). ECG progression was significant for epsilon waves (baseline 14% vs. follow-up 31%, p = 0.01) and QRS duration (111 ms vs. 114 ms, p = 0.04). Six patients with repolarization abnormalities according to the 2010 Task Force Criteria at baseline did not display these criteria at follow-up, whereas in all patients with epsilon waves at baseline these depolarization abnormalities also remained at follow-up. T wave inversions in inferior leads were common (36% of patients at baseline), and were significantly associated with major repolarization abnormalities (p = 0.02), extensive echocardiographic right ventricular involvement (p = 0.04), T wave inversions in lateral precordial leads (p = 0.05), and definite ARVC/D (p = 0.05). CONCLUSIONS Our data supports the concept that ARVC/D is generally progressive, which can be detected by 12-lead surface ECG. Repolarization abnormalities may disappear during the course of the disease. Furthermore, the presence of T wave inversions in inferior leads is common in ARVC/D.