Sebastian Jäckle

Persistent iatrogenic atrial septal defect after a single-puncture, double-transseptal approach for pulmonary vein isolation using a remote robotic navigation system: results from a prospective study

AIMS Persistent iatrogenic atrial septal defect (iASD) after transseptal puncture for pulmonary vein isolation (PVI) has been described recently as a complication of PVI. No data exists evaluating systematically the incidence and clinical implications of iASDs after PVI using a remote robotic navigation system (RNS) with sheaths with a distinct larger outer diameter. METHODS AND RESULTS In this prospective study, 40 patients with either paroxysmal (n = 22, 55%) or persistent symptomatic atrial fibrillation were treated with circumferential PVI using an RNS. In all patients, a single-puncture, double-transseptal approach was used to access the left atrium. Transoesophageal echocardiography was performed before and the day after PVI as well as after a 3 and 6 months follow-up (FU). The day after ablation an iASD was detected in 38 of 40 (95%) patients with a mean diameter of 3.45 +/- 1.5 mm. At 6-month FU, the iASDs were closed in 30 of 39 (78.9%) patients. During the 6-month FU period, no patient died or suffered from cerebral or cardiac embolism. CONCLUSION After a single-puncture, double-transseptal approach for PVI using the RNS, iASDs show a high spontaneous closure rate of 78.9% after a 6-month FU period. Persistent iASDs following PVI with the RNS are not associated with an increased rate of paradoxical embolism or with relevant shunting.

Religion, Religiosity, and the Attitudes Toward Homosexuality—A Multilevel Analysis of 79 Countries

Although attitudes toward homosexuality have become more liberal, particularly in industrialized Western countries, there is still a great deal of variance in terms of worldwide levels of homonegativity. Using data from the two most recent waves of the World Values Survey (1999–2004, 2005–2009), this article seeks to explain this variance by means of a multilevel analysis of 79 countries. We include characteristics on the individual level, as age or gender, as well as aggregate variables linked to specificities of the nation-states. In particular, we focus on the religious denomination of a person and her religiosity to explain her attitude toward homosexuality. We find clear differences in levels of homonegativity among the followers of the individual religions.

Initial experience with magnetic resonance imaging-safe pacemakers

Due of its superior soft tissue imaging capabilities, magnetic resonance imaging (MRI) has become the imaging modality of choice in many clinical situations, as illustrated by the tremendous growth in the number of MRIs performed over the past 2 decades. In parallel, the number of patients who require pacemakers or implantable cardiac defibrillators is increasing as indications for these devices broaden and the population ages. Taken together, these phenomena present an important clinical issue, as MR scans are generally contraindicated—except in urgent situations—in patients who have implanted cardiovascular devices. Potentially deleterious interactions between the magnetic fields and radio frequency (RF) energy produced by MR equipment and implantable devices have been identified, including inhibition of pacing, asynchronous/high-rate pacing, lead tip heating, and loss of capture. New devices that incorporate technologies to improve MR safety in patients with pacemakers have recently received approval in Europe and are under evaluation in the United States. Initial data from these devices suggest that these devices are safe in the MRI environment.

The dark side of the German ‘welcome culture’: investigating the causes behind attacks on refugees in 2015

Abstract In 2015, Germany experienced a record high influx of refugees – and received international praise for its ‘welcome culture’. At the same time, however, attacks on refugees rose to an alarming level. This article describes the distribution of these attacks and probes their causes, using detailed socioeconomic and political data while modelling a hierarchical data structure. Controlling for further relevant factors taken from the extant literature, the analysis first tests whether the strength of extreme right political parties plays a role and, second, it models a contagion effect, taking into account spatial as well as temporal proximity. The findings suggest that the strength of right-wing parties in a district considerably boosts the probability of attacks on refugees in that area. They also corroborate the idea of behavioural contagion. The set of social-structural variables employed as controls yielded only limited explanatory power.

Comparison of cardiogoniometry and electrocardiography with perfusion cardiac magnetic resonance imaging and late gadolinium enhancement

AIMS Cardiogoniometry (CGM) is a spatio-temporal five-lead resting electrocardiographic method utilizing automated analysis. The purpose of this study was to determine CGMs and electrocardiography (ECG)s accuracy for detecting myocardial ischaemia and/or lesions in comparison with perfusion cardiac magnetic resonance imaging (CMRI) and late gadolinium enhancement (LGE). METHODS AND RESULTS Forty (n= 40) patients with suspected or known stable coronary artery disease were examined by CGM and resting ECG directly prior to CMRI including adenosine stress perfusion (ASP) and LGE. The investigators visually reading the CMRI were blinded to the CGM and ECG results. Half of the patients (n= 20) had a normal CMRI while the other half presented with either abnormal ASP and/or detectable LGE. Cardiogoniometry yielded an accuracy of 83% (sensitivity 70%) and ECG of 63% (sensitivity 35%) compared with CMRI. CONCLUSIONS In this pilot study CGM compares more favourably than ECG with the detection of ischaemia and/or structural myocardial lesions on CMRI.

Patterns of Publishing in Political Science Journals: An Overview of Our Profession Using Bibliographic Data and a Co-Authorship Network

We constructed a co-authorship network of the global political science community. Two scientists are connected if they have co-authored a paper. We drew on more than 67,000 papers published from 1990 to 2013 in one of today’s 96 core journals. The network consists of more than 40,000 authors located worldwide. We found that the community forms a single, interconnected component as well as numerous unconnected authors. Whereas some are highly productive in terms of publications, the majority of authors published only a single paper, which suggests significant turnover in the community. Using information from the papers (e.g., title, journal, and abstract), we investigated how different subcommunities organize and interconnect, how journals reach out into the community, and how individual scientists cooperate. We also investigated how the network has evolved in the last two decades. Our analysis is supplemented by a bibliographic analysis that describes major changes in publication patterns.

“New terrorism” = higher brutality? An empirical test of the “brutalization thesis”

Abstract This article focuses on the so-called “brutalization” of terrorism. The brutalization thesis as part of the larger theoretical concept of “new terrorism” argues that “new terrorism” is more brutal than “old terrorism.” Many scholars claim that the 9/11 attacks mark the beginning of a new era of terrorism that has lifted international as well as domestic terrorism to a new level of violent brutality. Others argue that this process had already started in the early 1990s. After discussing possible ways to operationalize a brutalization of terrorism, for example focusing on suicide bombings or terrorist attacks against soft targets, this article tests the empirical credibility of the brutalization thesis regarding both potential starting points. Data from the Global Terrorism Database (GTD) shows that only three out of nine indicators increased significantly during the 1990s, partially backing the idea of a general brutalization, whereas increasing numbers of suicide attacks and beheadings after 9/11 support the notion of a qualitative change in terrorism and its brutality connected with the idea of maximizing media and public attention. Yet, these developments are regionally limited and the brutality of this “new terrorism” exceeds the levels known from the zenith of “old terrorism” in the 1970s and 1980s in only a few cases.

Sooner or later: the influence of public opinion and religiosity on the enactment of laws recognizing same-sex unions

ABSTRACT Starting in the 1990s, almost all Western democracies recognized same-sex partnerships within just over two decades. This study examines which factors accelerated or decelerated these legal changes. It focuses on the effects of several facets of culture: attitudes towards homosexuality in general; attitudes towards gays and lesbians as people; and religiosity. An event history analysis of 19 Western countries shows that the less tolerant people are of gays and lesbians and the greater a country’s percentage of regular attendees of religious services, the longer the time until a same-sex union law is introduced. The results provide new insights into policy effects of culture and point out the importance of distinguishing between the various elements of public opinion.

Event-History-Analyse

Die Event-History-Analyse (EHA) ist eine statistische Methode, welche auf den Wechsel von Untersuchungsobjekten von einem Zustand in einen anderen fokussiert. Ein solcher Zustandswechsel wird als Ereignis bezeichnet. Relevant ist zudem die Dauer, die ein Objekt in einem bestimmten Zustand verweilt, bis es ein Event erfahrt. In der Medizin will man beispielsweise nicht nur wissen, ob ein Patient uberlebt, sondern wie lange er uberlebt und ob eine bestimmte Therapieform seine Uberlebensdauer verlangert. Die abhangige Variable ist dort entsprechend die Dauer, die die Person uberlebt, bis ihr das Ereignis Tod, widerfahrt. Untersucht wird also der Zustandswechsel von „lebendig“ zu „tot“. Um Transitionsprozesse sinnvoll untersuchen zu konnen, mussen drei Bedingungen erfullt sein: erstens muss sich jedes Untersuchungsobjekt auf eine bestimmte Anzahl an moglichen Endzustanden zubewegen, zweitens mussen diese Zustandswechselereignisse generell zu jedem Zeitpunkt eintreten konnen und drittens geht man davon aus, dass es bestimmte zeitkonstante und/oder zeitvariable Faktoren gibt, die das Eintreten der Ereignisse beeinflussen.

Lineare und logistische Regression

Das folgende Kapitel uber die lineare OLS-Regression setzt basale Kenntnisse voraus, die ublicherweise ein Gegenstand von Einfuhrungsbuchern sind, welche in Lehrveranstaltungen der Bachelor-Studiengange verwendet werden. Wir gehen deshalb nicht noch einmal auf die Darstellung der Regressionsgleichung und die Streuungszerlegung in einem bivariaten Streudiagramm ein und konzentrieren uns stattdessen auf die multiple Regression. Wer die Grundlagen noch einmal auffrischen will, findet eine kompakte Darstellung in Gehring und Weins.