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In my paper I claim that methodology inspired by postcolonial theory not only unearths how Western international institutions perpetuate hegemonic truth claims, but that at the same time engaging in a “learning to learn from below” might sense irritations within these truth claims which can open up spaces to think beyond truth in a sense of a justice to come. (Derrida 2002) Since the (mis)understanding of knowledge production as truth finding is constitutive of both, the scientific and the legal discourse, the engagement in such research accordingly has the potential to unfold a twofold deconstructive force...
"European" interventions
(2017)
While conflicts can be managed and resolved to the extent of peace keeping, evolving to state of peace and peace society is a far larger and challenging experience. The armed forces by definition and global practice are nurtured and trained to violence. However, it takes a lot more time and enough maturity and strength for a non-violent struggle...
Far-right parties gained considerable support in many European countries in recent years. Austria comes within a whisker of becoming the first country in the history of the European Union to elect a far-right president, Horbert Hofer, the candidate from the Freedom Party. Similarly, in France, Marie Le Pen is expected to be Front National’s (FN) candidate in the 2017 presidential election and probably to make it to the second round of voting...
Security, arms control, disarmament and confidence building measures in the Baltic sea region
(2017)
Taking into consideration the stalemete of all disarmament negotiations as well as the worsening situation in the Baltic Sea region, I would like to present another paper as well, discussing the security trends in the Baltic Sea region and the potential of confidence building measures in this region as well as to discuss in this context the prospects of arms control and disarmament in general as well as specifically in Europeparticularly in the Baltic Sea region...
Conflict and insecurity have largely been the major driving factors behind the current wave of population influx in Europe. It is desirable that to understand the current migrant crisis in Europe, it is essential to understand the nature of the on-going conflict and existing insecurities in the home states from where the migrants are coming...
When Donald Trump arrived to power, many experts were concerned regarding his ideas on U.S. nuclear weapons. Particular attention was paid to his tweet about strengthening the U.S. nuclear arsenal after 25 years of the consistent WMD-disarmament under "The Cooperative Threat Reduction Program" (aka "Nunn-Lugar Program" an array of START treaties). In that preiod, U.S. and Russia removed more than 8,000 warheads and elements of the nuclear triad – submarines, ICBMs and long-range bombers. Now, experts worry that Trump’s aspirations will bury the U.S.-Russian nuclear cooperation aimed at global security...
Rethinking concepts of peace
(2017)
Motivated by a structural blind spot of Peace Studies regarding the (manifoldness of) definitions of its central concept "peace", I argue that this blind spot is especially manifested in the Eurocentric view on peace. My claim: Non-"Western" concepts of peace should be considered more in Peace Studies...
The overall aim of my work is to contribute to a future theory of epistemic violence – thereby enabling us to gain a better understanding of the various forms of direct, physical violence which are usually analysed within peace studies, IR, political theory and related fields. My perspective starts from transdisciplinary peace studies, is concerned with the sociology of knowledge, and informed by post- and de-colonial theory as well as by feminist critique and political theory...
For feminists, reflexivity has always meant more than a methodological tool...
AFK-EUPRA – 13 : feminist interventionism, postcolonial critique and non-western feminist approaches
(2017)
The study I would like to present concerns ethnically mixed borderland communities caught in a trap of competing national narratives spread from the surrounding states. I conduct an ethnographic research on a rare contemporary case of peaceful co-living of Armenian and Azerbaijani communities, which takes place in rural areas of Georgia’s southern borderland...
The concept of the "comprehensive approach" has become a paradigm for international state engagement in the field of fostering sustainable peace in crisis-ridden countries. This approach stipulates joint actions of different governmental institutions. The ministry of defence, providing interventionist armed forces; the ministry of interior, providing police personal; the ministry of foreign affairs, providing crisis aid and the ministry of economic cooperation and development define the core actors on the highest level, whilst the implementation of this approach is left to the various, highly heterogeneous employees of the ministries and their sub-contractors...
Armed resistance by interest groups against governments, their policies and symbols has a long history all across the world. During the currency of resistance movement, given the checkered stake holder ship in the conflict, weapon supply to funding of the myriad resistance groups has been a regular modus operandi to generate resistance movement funding...
Women’s protection has been largely discussed in conflict and gender scholarship and promoted as a key priority for governments, NGOs and international community. However, when critically analysed, the meaning of protection in conflict settings and the understanding of who should provide protection in emergencies, conflict and complex humanitarian crisis remain ambiguous. In long-term conflict settings for example, it is unclear whose role it is to protect civilians...
The paper introduces the socio-anthropological concept of international representations to examine the relationship between a civilizational rhetoric, the West European and the international politics of otherization and containment of Southeast Europe, and an essentialist and timeless bias in international relations theory, including both radical and constructivist trends...
Much of today’s conflicts and challenges, globally and locally, can be in part attributed to or are influenced by the hegemony of Western over non-Western cultures and politics. Long-standing and still reproduced Western dominance and power are directed at the protection of own interests, thereby re-creating power imbalances, inequalities and practices of exclusion...
Consensus modality : accommodating parties and containing overt violence in Nepal’s peace process
(2017)
Throughout this decade, most of the literatures in social sciences on Nepal contain Maoist Armed Conflict (1996-2006) in its introduction part. The country is in constant political turmoil even after the Comprehensive Peace Accord of 2006 between Government of Nepal and then rebel force. Since the peace agreement, Nepalese society has observed diverse socio-political tensions in different forms and become fragile society. Nepal is exerting a growing concern on international politics because of the complication in the peace process of ensuring sustainable peace, stability and economic progress. The implications for peace, stability and economic development in fragile countries present a challenge to the international community (In Grävingholt et al, 2013). Political culture and social structure are empirically related to political stability (Lijphart, 1969: 208). So we cannot separate our social and cultural context with the idea of stability...
Regional actors like the European Union (EU) and the African Union (AU) are increasingly seeking to conceptualize their transitional justice engagements through policy frameworks and carve out spaces for themselves in transitional justice processes. While the EU adopted its Policy Framework on Support to Transitional Justice in November 2015, the AU is still in the process of developing its African Transitional Justice Framework. It is the starting assumption of this paper that the policy discourses inevitably have an effect on the understanding, scope and institutionalization of transitional justice that these two regional bodies will support – the EU mostly as a development strategy outside and the AU within its borders...
International mediation has traditionally been understood as an instrument aimed at getting political representatives to agree on a negotiated settlement. However, in cases where referendums were required for ratification, peace agreements have been rejected bythe people. This paper uncovers how mediators can help political leaders reach agreementsthat are supported by the people they represent by comparing the Annan Plan and Good Friday Agreement (GFA) mediations and referendums in Cyprus and Northern Ireland, respectively...
Who is Ângkar? The nature of authority and responsibility under the Khmer Rouge Forme cadres of the Khmer Rouge today still speak of Ângkar, the organisation of the Khmer Rouge, with the utmost respect and subservience. Unlike in other genocidal regimes in which state actors played an important role, such as the NSDAP and SS in the Holocaust or Ittihad in the Ottoman genocide of the Armenians, Ângkar cannot be reduced merely to the name of the party organisation of the Khmer Rouge. Although Ângkar is a concept known to all in Cambodia and remains synonymous with absolute authority and the necessity for unwavering obedience, there is a broad variety of perspectives when trying to state who or what Ângkar actually is...
GOeTHEO : Ausgabe 15
(2016)
When is a crisis a crisis?
(2017)
The refugee and migration crisis has contributed to promote and consolidate new practices. The NGOs’ SAR Operations represent a new aspect of the humanitarian new normal phenomenon which is here analysed to deepen the existing knowledge about the response of the state, the citizens and the organised civil society to the crisis. The paper, which is based on an expert survey research conducted by researchers of the University of Catania, contends that Europeans overwhelmingly perceive irregular migrants as a threat...
In the past years a variety of papers have been presented by the European Commission and by the EU High Representative, outlining strategies of the EU in foreign-, security- and refugee policies. Many of these strategic documents reflect the ambivalence of the EU Policy. On the one hand the complementarity and coherence of approaches is emphasized; on the other hand, core elements of the foreign-, security- and refugee policy undermine aims in other policy fields...
Threat perceptions is a popular topic among scholars of international relations, yet the focus is oftentimes how two states perceive and misperceive threats (Robert Jervis, David Singer among others). Threats are generally understood as potential harm directed against the territorial integrity or the political regime of the states in question or both. Wandering on the borders of the mainstream realist theory and the rational choice theory – popular since when behavioralism entered into IR literature in the 1960s – and the constructivism of the reflectivist era (Wendt), the topic has been made a subject of study through such several different conceptual lenses but mostly on an international/state level of analysis a la Waltz...
The paper will outline a research project – its goals and methods – that focuses on what 1) makes humans flee from their home, land and country, at the risk of losing their lives, 2) seek refuge in another place, 3) what individual assessments they made before, during and after flight, and 4) how they assess the question of return to their countries/places of origin when the original causes of their flight – e.g. civil unrest, civil strife or civil war – are not any more directly present in the country or place from which they fled...
Exodus Eritrea
(2017)
The post-liberal debate on peacebuilding and reconciliation seems to have advanced. We observe efforts “bringing the local back in” (Debiel/Rink 2016) by enhancing local ownership, relational sensitivity, contextualization, culturalization, hybridity and last but not least resilience. Concepts furthermore try to integrate transnational dynamics, international power shifts and trends of regionalization. However, many questions remain: for scholars, for practitioners and last but not least for the local population...
How do coalition governments affect the risk of civil war onset in ethnically divided societies? Existing research argues that power-sharing coalitions decrease the risk of civil war because they redress grievances. Building on a formal model of coalition formation, we predict that ethnic elites are most likely to form oversized rather than minimum-winning coalitions in anticipation of future challenges to the regime. Put differently, we expect most power-sharing to occur where the risk of regime-threatening civil war is highest...
This year’s conference of the AFK (German Association for Peace and Conflict Studies) and the European Peace Research Association (EuPRA) is on "Peace and Conflict Studies from the Margins to the Centre; Rethinking Europe in an Unequal World" (16 – 18 March 2017 in Schwerte (nearby Dortmund), Germany).
The virtual realm of the internet is often seen as an egalitarian world where differences such as those between young and established researchers do not seem so significant. While we do not fully agree with this thesis, we want to use this blog to make a model attempt at providing a platform in which those participating in the conference and others can enter discussion with young students, established researchers, and peace activists.
To make this possible, we started a project in cooperation with the Bretterblog – a young team of researchers who established this blog some years ago. Here we will discuss the topics of the conference and will inform a broader audience about the newest results in peace and conflict research from different countries.
Great interest has emerged recently in the search for Kitaev spin liquid states in real materials. Such states rely on strongly anisotropic magnetic interactions, which have been suggested to exist in a number of candidate materials based on Ir and Ru. This thesis concentrates on two priority purposes. The first is the investigation of electronic and magnetic properties of candidate materials Na2IrO3, α-Li2IrO3, α-RuCl3, γ-Li2IrO3, and Ba3YIr2O9 for Kitaev physics where both spin-orbit coupling and correlation effects are important. The second is the method development for the microscopic description of correlated materials combining many-body methods and density functional theory (DFT). ...
In this thesis we explore the characteristics of strongly interacting matter, described by Quantum Chromodynamics (QCD). In particular, we investigate the properties of QCD at extreme densities, a region yet to be explored by first principle methods. We base the study on lattice gauge theory with Wilson fermions in the strong coupling, heavy quark regime. We expand the lattice action around this limit, and carry out analytic integrals over the gauge links to obtain an effective, dimensionally reduced, theory of Polyakov loop interactions.
The 3D effective theory suffers only from a mild sign problem, and we briefly outline how it can be simulated using either Monte Carlo techniques with reweighting, or the Complex Langevin flow. We then continue to the main topic of the thesis, namely the analytic treatment of the effective theory. We introduce the linked cluster expansion, a method ideal for studying thermodynamic expansions. The complex nature of the effective theory action requires the development of a generalisation of the linked cluster expansion. We find a mapping between generalised linked cluster expansion and our effective theory, and use this to compute the thermodynamic quantities.
Lastly, various resummation techniques are explored, and a chain resummation is implemented on the level of the effective theory itself. The resummed effective theory describes not only nearest neighbour, next to nearest neighbour, and so on, interactions, but couplings at all distances, making it well suited for describing macroscopic effects. We compute the equation of state for cold and dense heavy QCD, and find a correspondence with that of non-relativistic free fermions, indicating a shift of the dynamics in the continuum.
We conclude this thesis by presenting two possible extensions to new physics using the techniques outlined within. First is the application of the effective theory in the large-$N_c$ limit, of particular interest to the study of conformal field theory. Second is the computation of analytic Yang Lee zeros, which can be applied in the search for real phase transitions.
Die Rede vom Parasiten mit vorrangig pejorativer Bedeutung ist semantisch relativ stabil und kann auf den botanischen Fachterminus 'Parasit' bis ins 16. Jahrhundert zurückverfolgt werden. Allerdings muss eine vollständige Geschichte des Parasiten, die allerdings hier nicht geleistet werden kann, sondern sich auf kursorische Hinweise beschränken muss, bis in die Antike zurückgehen und ist dabei deutlich ambivalenter, als es zunächst scheint. Vor allem bleibt eine Begriffsgeschichte des 'Parasiten' unvollständig, wenn sie neben dem biologischen Konzept nicht auch die mit ihm verknüpften Diskurse reflektiert, die die Figur in andere Zusammenhänge und Bewertungskontexte stellen - vor allem die der menschlichen Gesellschaft. Der Parasit als Begriff besitzt prinzipiell unscharfe Grenzen, da der Parasit immer schon ein Agent der Zwischenräume gewesen ist.
Im Folgenden soll exemplarisch aufgezeigt werden, wie die begriffsgeschichtlich entscheidende Koppelung von Evolution und Fortschritt im Neoevolutionismus zunächst explizit verteidigt (und reformuliert) und später aufgekündigt wird und zerbricht. Es soll also einer Transformation der Geschichtssemantik 'innerhalb' des Neoevolutionismus nachgegangen werden, das heißt im Wesentlichen den Gemeinsamkeiten und Unterschieden zwischen dem ethnologischen Neoevolutionismus Whites, der den Fortschrittsbegriff wissenschaftlich retten und objektivieren will, und der Neukonfiguration des Neoevolutionismus, in der eine gleichsam evolutionistische Axiomatik zur Zurückweisung des Fortschrittsbegriffs führt, die sich vor allem bei Steward und in jüngster Zeit bei Diamond findet. Dabei ist zu berücksichtigen, dass das Deutungsmuster geschichtlicher Entwicklung von Kulturen und Gesellschaften, das der Neoevolutionismus anbietet, nicht nur in diachroner Dimension neuen Voraussetzungen angepasst wird (immerhin liegen zwischen der Formung des Neoevolutionismus bei White und Steward und dessen Aktualisierung und Popularisierung bei Diamond mehrere Dekaden), sondern auch aus dem wissenschaftlichen Spezialdiskurs in den Bereich der Populärwissenschaft übertragen wird. Begriffsgeschichtlich interessant ist hierbei also, dass sowohl die Grenze zwischen den 'Zwei Kulturen' in der Wissenschaft (und auch die interdiskursiv lange tradierte zwischen Natur und Kultur als zwei klar unterschiedenen Sphären), als auch diejenige zwischen verschiedenen Kommunikationsbereichen berührt wird. Dazu soll die Verteidigung des Fortschrittsbegriffs bei White genauer vorgestellt werden, bei der der Begriff notwendiger Bestandteil des Evolutionismus ist, um vor diesem Hintergrund die Aufkündigung der Koppelung von Evolution und Fortschritt bei Steward und im populären Evolutionismus zu skizzieren.
In diesem Beitrag werde ich versuchen, zwei auf den ersten Blick recht disparate Stränge des 'Kultur'-Diskurses miteinander in Beziehung zu setzen: den politisch-interdiskursiven Gebrauch von 'Kultur' und den begriffspolitisch interessanten Versuch populärer Evolutionsbiologen, den Kulturbegriff biologisch zu erden bzw. umzudefinieren. Beide Stränge partizipieren hierzulande nolens volens an den konnotativen Ladungen, die 'Kultur' angesammelt hat, und beide Stränge sind dabei, Gewicht und Verteilung dieser Ladungen erheblich zu verändern.
Die Begriffsgeschichte befindet sich seit einigen Jahren in der Phase einer grundlegenden Transformation, die sich vor allem in ihrer zunehmenden Internationalisierung und Interdisziplinarisierung sowie in ihrer Verbindung mit der Kultur- und Wissenschaftsgeschichte dokumentiert. Eine besondere Herausforderung bildet dabei die Erschließung der naturwissenschaftlichen Semantik. Referenzpunkte für die gegenwärtige inhaltliche und methodische Neuausrichtung bilden unter anderem die Ansätze zu einer Historischen Epistemologie (Gaston Bachelard, Ludwik Fleck) sowie Georges Canguilhems methodische Fundierung der Wissenschaftsgeschichte in der Begriffsgeschichte. In diesem Aufsatz möchte ich einige Aspekte einer interdisziplinären Begriffs- und Wissenschaftsgeschichte anhand der Analyse der Entstehungsphase des Konzepts vom 'Survival of the fittest' diskutieren. Dieses Konzept hat sich im Zeitraum der 1860er bis 1870er Jahre zu einem Deutungsmuster entwickelt, das mit eminent politischen Folgen im Spannungsfeld biologischer, philosophischer, soziologischer, ethnologischer und ökonomischer Theoriebildung sowie zwischen verschiedenen nationalen Wissenschaftskulturen zirkulierte. Ich möchte betonen, dass die von mir fokussierte wissenshistorische Konstellation nur einen kleinen Ausschnitt aus der komplexen und weit verzweigten Geschichte des Überlebensbegriffs bildet. Insbesondere seit den 1970er Jahren im Zusammenhang der ökologischen Krise und als Effekt der Diskursmacht der von Foucault entwickelten Konzepte der Biopolitik bzw. Biomacht lässt sich eine neue Konjunktur des Überlebensbegriffs ausmachen, die bis in unsere Gegenwart reicht und die überhaupt die Voraussetzung für das Bedürfnis bildet, die Bedeutungs- und Gebrauchsgeschichte des Überlebensbegriffs, oder einzelne Etappen und Knotenpunkte derselben, zu rekonstruieren.
Anführungszeichen als Symptom : zum historischen Bedeutungs- und Funktionswandel einer Zeichenform
(2013)
In diesem Beitrag möchte ich mich mit einer Zeichenform befassen, die auf den ersten Blick unscheinbar und trivial zu sein scheint: den Anführungszeichen, die man salopp auch Gänsefüßchen oder Hasenöhrchen nennt. Für die Historische Semantik und Begriffsgeschichte ist die Bedeutung dieser Zeichen längst erkannt. Wie Martin Wengeler im Anschluss an Ludwig Jäger und Dietrich Busse herausgestellt hat, handelt es sich bei der Verwendung von Anführungszeichen um eine sprachreflexive Äußerung, der insbesondere für die Analyse des politischen Sprachgebrauchs eine Anzeigerfunktion zukommt - wird doch an ihnen eine bewusste Distanzierung von bestimmten Sprachgebräuchen und Wortverwendungsweisen greifbar. Nach Wengeler lösen explizite Wortthematisierungen zumindest ansatzweise das Problem des Auffindens von Belegstellen, die das Auftauchen neuer oder den Plausibilitätsverlust älterer Bedeutungen anzeigen. Mit ihrer Analyse werden Schwellen vom okkasionellen zum usuellen Wortgebrauch sichtbar und die Erfassung des Auftretens semantischer Innovationen stärker objektivierbar. Besonders in den sprachgeschichtlichen Forschungen der Düsseldorfer Schule ist deshalb das Aufsuchen von in Form von Anführungszeichen explizit gemachten Sprachthematisierungen zu einer "zentralen 'Findungsmethode'" gemacht worden. So weit ich sehe ist diese Methode punktuell in Bezug auf die Verwendung einzelner Wörter in Anschlag gebracht worden, was sich mit dem besonderen Interesse am politischen Sprachgebrauch und insbesondere am Einsatz 'brisanter Wörter' begründen lässt. Im Unterschied dazu geht es mir im vorliegenden Beitrag nicht primär um die Analyse einzelner Verwendungen, sondern - auf einer verallgemeinernden Ebene - um die Herausarbeitung eines grundlegenden historischen Bedeutungs- und Funktionswandels des Einsatzes dieser Zeichenform. Im ersten Teil gehe ich kurz auf deren (Vor-)Geschichte ein, um mich dann im zweiten Teil zwei Feldern zuzuwenden, in denen diese Zeichen nicht nur häufig, sondern, worauf es mir ankommt, in einem epistemisch neuen Sinne eingesetzt worden sind, nämlich im Zusammenhang der Auseinandersetzung mit den Folgen der Shoah und der Entwicklung der Atomwaffen. Ausblickhaft möchte ich dann noch die Frage aufwerfen, was es mit der zu beobachtenden Generalisierung der neuen Funktionen der Anführungszeichen auf sich haben könnte.
The Future of the Noosphere
(2014)
In this article, a Koselleckian approach to the issue of time will be employed. In Koselleck's view, modernity has been characterized by a multiplicity of synchronous times, or as Helge Jordheim puts it, by "multiple temporalities". By temporality, Koselleck means something different than epochs or periodizations. More precisely, Jordheim asserts, Koselleck uses this term to reach for experiences of time, such as "progress, decadence, acceleration, or delay, the 'not yet' and the 'no longer', the 'earlier' or 'later than', the 'too early' and the 'too late', situation and the duration". Especially pertinent for this article is Koselleck's category of a horizon of expectations (Erwartungshorizont), understood as perceived prospects for the future. In both the noosphere and the Anthropocene discussion, the notion of an Age of Man seems to merge different timescales into one another, or, as stated by one of the most prominent scientists in the early debate, "The division of historical and geological time is levelled out for us". This article examines the temporality implied in the noosphere concept in order to formulate a specific question regarding the Anthropocene. The article is thus intended to contribute to the on-going examination of the Anthropocene concept by way of historicising its temporality.
Background: Long noncoding RNAs (lncRNAs) are non-protein coding transcripts regulating a variety of physiological and pathological functions. However, their implication in heart failure is still largely unknown. The aim of this study is to identify and characterize lncRNAs deregulated in patients affected by ischemic heart failure.
Methods: LncRNAs were profiled and validated in left ventricle biopsies of 18 patients affected by non end-stage dilated ischemic cardiomyopathy and 17 matched controls. Further validations were performed in left ventricle samples derived from explanted hearts of end-stage heart failure patients and in a mouse model of cardiac hypertrophy, obtained by transverse aortic constriction. Peripheral blood mononuclear cells of heart failure patients were also analyzed. LncRNA distribution in the heart was assessed by in situ hybridization. Function of the deregulated lncRNA was explored analyzing the expression of the neighbor mRNAs and by gene ontology analysis of the correlating coding transcripts.
Results: Fourteen lncRNAs were significantly modulated in non end-stage heart failure patients, identifying a heart failure lncRNA signature. Nine of these lncRNAs (CDKN2B-AS1/ANRIL, EGOT, H19, HOTAIR, LOC285194/TUSC7, RMRP, RNY5, SOX2-OT and SRA1) were also confirmed in end-stage failing hearts. Intriguingly, among the conserved lncRNAs, h19, rmrp and hotair were also induced in a mouse model of heart hypertrophy. CDKN2B-AS1/ANRIL, HOTAIR and LOC285194/TUSC7 showed similar modulation in peripheral blood mononuclear cells and heart tissue, suggesting a potential role as disease biomarkers. Interestingly, RMRP displayed a ubiquitous nuclear distribution, while H19 RNA was more abundant in blood vessels and was both cytoplasmic and nuclear. Gene ontology analysis of the mRNAs displaying a significant correlation in expression with heart failure lncRNAs identified numerous pathways and functions involved in heart failure progression.
Conclusions: These data strongly suggest lncRNA implication in the molecular mechanisms underpinning HF.
Background: In German breast cancer care, the S1-guidelines of the 1990s were substituted by national S3-guidelines in 2003. The application of guidelines became mandatory for certified breast cancer centers. The aim of the study was to assess guideline adherence according to time intervals and its impact on survival.
Methods: Women with primary breast cancer treated in three rural hospitals of one German geographical district were included. A cohort study design encompassed women from 1996–97 (N = 389) and from 2003–04 (N = 488). Quality indicators were defined along inpatient therapy sequences for each time interval and distinguished as guideline-adherent and guideline-divergent medical decisions. Based on all of the quality indicators, a binary overall adherence index was defined and served as a group indicator in multivariate Cox-regression models. A corrected group analysis estimated adjusted 5-year survival curves.
Results: From a total of 877 patients, 743 (85 %) and 504 (58 %) were included to assess 104 developed quality indicators and the resuming binary overall adherence index. The latter significantly increased from 13–15 % (1996–97) up to 33–35 % (2003–04). Within each time interval, no significant survival differences of guideline-adherent and -divergent treated patients were detected. Across time intervals and within the group of guideline-adherent treated patients only, survival increased but did not significantly differ between time intervals. Across time intervals and within the group of guideline-divergent treated patients only, survival increased and significantly differed between time intervals.
Conclusions: Infrastructural efforts contributed to the increase of process quality of the examined certified breast cancer center. Paradoxically, a systematic impact on 5-year survival has been observed for patients treated divergently from the guideline recommendations. This is an indicator for the appropriate application of guidelines. A maximization of guideline-based decisions instead of the ubiquitous demand of guideline adherence maximization is advocated.
Eosinophilic cholangitis is a potentially underdiagnosed etiology in indeterminate biliary stricture
(2017)
AIM: To investigate presence and extent of eosinophilic cholangitis (EC) as well as IgG4-related disease in patients with indeterminate biliary stricture (IBS).
METHODS: All patients with diagnosis of sclerosing cholangitis (SC) and histopathological samples such as biopsies or surgical specimens at University Hospital Frankfurt from 2005-2015 were included. Histopathological diagnoses as well as further clinical course were reviewed. Tissue samples of patients without definite diagnosis after complete diagnostic work-up were reviewed regarding presence of eosinophilic infiltration and IgG4 positive plasma cells. Eosinophilic infiltration was as well assessed in a control group of liver transplant donors and patients with primary sclerosing cholangitis.
RESULTS: one hundred and thirty-five patients with SC were included. In 10/135 (13.5%) patients, no potential cause of IBS could be identified after complete diagnostic work-up and further clinical course. After histopathological review, a post-hoc diagnosis of EC was established in three patients resulting in a prevalence of 2.2% (3/135) of all patients with SC as well as 30% (3/10) of patients, where no cause of IBS was identified. 2/3 patients with post-hoc diagnosis of EC underwent surgical resection with suspicion for malignancy. Diagnosis of IgG4-related cholangitis was observed in 7/135 patients (5.1%), whereas 3 cases were discovered in post-hoc analysis. 6/7 cases with IgG4-related cholangitis (85.7%) presented with eosinophilic infiltration in addition to IgG4 positive plasma cells. There was no patient with eosinophilic infiltration in the control group of liver transplant donors (n = 27) and patients with primary sclerosing cholangitis (n = 14).
CONCLUSION: EC is an underdiagnosed benign etiology of SC and IBS, which has to be considered in differential diagnosis of IBS.
Very few people doubt that it is a fundamental demand of justice that members of legal-political normative orders ought to have legal rights that define their basic standing as subjects of such an order. But when it comes to the concrete understanding of such rights, debates abound. What is the nature of these rights – are they an expression of the sovereign will of individuals, or are they based on important human interests? How should these rights be justified – do they have a particular moral ground, and if so, only one or many?
Long noncoding RNAs (lncRNAs) are non-protein coding RNAs regulating gene expression. Although for some lncRNAs a relevant role in hypoxic endothelium has been shown, the regulation and function of lncRNAs is still largely unknown in the vascular physio-pathology. Taking advantage of next-generation sequencing techniques, transcriptomic changes induced by endothelial cell exposure to hypoxia were investigated. Paired-end sequencing of polyadenylated RNA derived from human umbilical vein endothelial cells (HUVECs) exposed to 1% O2 or normoxia was performed. Bioinformatics analysis identified ≈2000 differentially expressed genes, including 122 lncRNAs. Extensive validation was performed by both microarray and qPCR. Among the validated lncRNAs, H19, MIR210HG, MEG9, MALAT1 and MIR22HG were also induced in a mouse model of hindlimb ischemia. To test the functional relevance of lncRNAs in endothelial cells, knockdown of H19 expression was performed. H19 inhibition decreased HUVEC growth, inducing their accumulation in G1 phase of the cell cycle; accordingly, p21 (CDKN1A) expression was increased. Additionally, H19 knockdown also diminished HUVEC ability to form capillary like structures when plated on matrigel. In conclusion, a high-confidence signature of lncRNAs modulated by hypoxia in HUVEC was identified and a significant impact of H19 lncRNA was shown.
Measles virus (MeV) is an aerosol-borne and one of the most contagious pathogenic viruses known. Almost every MeV infection becomes clinically manifest and can lead to serious and even fatal complications, especially under conditions of malnutrition in developing countries, where still 115,000 to 160,000 patients die from measles every year. There is no specific antiviral treatment. In addition, MeV infections cause long-lasting memory B and T cell impairment, predisposing people susceptible to opportunistic infections for years. A rare, but fatal long-term consequence of measles is subacute sclerosing panencephalitis. Fifteen years ago (2001), WHO has launched a programme to eliminate measles by a worldwide vaccination strategy. This is promising, because MeV is a human-specific morbillivirus (i.e. without relevant animal reservoir), safe and potent vaccine viruses are sufficiently produced since decades for common application, and millions of vaccine doses have been used globally without any indications of safety and efficacy issues. Though the prevalence of wild-type MeV infection has decreased by >90 % in Europe, measles is still not eliminated and has even re-emerged with recurrent outbreaks in developed countries, in which effective vaccination programmes had been installed for decades. Here, we discuss the crucial factors for a worldwide elimination of MeV: (1) efficacy of current vaccines, (2) the extremely high contagiosity of MeV demanding a >95 % vaccination rate based on two doses to avoid primary vaccine failure as well as the installation of catch-up vaccination programmes to fill immunity gaps and to achieve herd immunity, (3) the implications of sporadic cases of secondary vaccine failure, (4) organisation, acceptance and drawbacks of modern vaccination campaigns, (5) waning public attention to measles, but increasing concerns from vaccine-associated adverse reactions in societies with high socio-economic standards and (6) clinical, epidemiological and virological surveillance by the use of modern laboratory diagnostics and reporting systems. By consequent implementation of carefully designed epidemiologic and prophylactic measures, it should be possible to eradicate MeV globally out of mankind, as the closely related morbillivirus of rinderpest could be successfully eliminated out of the cattle on a global scale.
An accurate quantification of low viremic HCV RNA plasma samples has gained importance since the approval of direct acting antivirals and since only one single measurement predicts the necessity of a prolonged or shortened therapy. As reported previously, HCV quantification assays such as Abbott RealTime HCV and Roche COBAS AmpliPrep/COBAS TaqMan HCV version 2 (CTM v2) may vary in sensitivity and precision particularly in low-level viremia. Importantly, substantial variations were previously demonstrated between some of these assays compared to the Roche High Pure System/COBAS TaqMan assay (HPS) reference assay, which was used to establish the clinical decision points in clinical studies. In this study, the reproducibility of assay performances across several laboratories was assessed by analysing quantification results generated by six independent laboratories (3× RealTime, 3× CTM v2) in comparison with one HPS reference laboratory. The 4th WHO Standard was diluted to 100, 25 and 10 IU/ml, and aliquots were tested in triplicates in 5 independent runs by each assay in the different laboratories to assess assay precision and detection rates. In a second approach, 2 clinical samples (GT 1a & GT 1b) were diluted to 100 and 25 IU/ml and tested as described above. While the result range for WHO 100 IU/ml replicates across all laboratories was similar in this analysis, the CVs of each laboratory ranged from 19.3 to 25.6 % for RealTime laboratories and were lower than CVs of CTM v2 laboratories with a range of 26.1–47.3 %, respectively, and also in comparison with the CV of the HPS reference laboratory (34.9 %). At WHO standard dilution of 25 IU/ml, 24 replicates were quantified by RealTime compared to 8 replicates with CTM v2. Results of clinical samples again revealed a higher variation of CTM v2 results as compared to RealTime values. (CVs at 100 IU/ml: RealTime: 13.1–21.0 % and CTM v2: 15.0–32.3 %; CVs at 25 IU/ml: RealTime 17.6–34.9 % and CTM v2 28.2–54.9 %). These findings confirm the superior precision of RealTime versus CTM v2 at low-level viremia even across different laboratories including the new clinical decision point at 25 IU/ml. A highly precise monitoring of HCV viral load during therapy will remain crucial for patient management with regard to futility rules, therapy efficacy and SVR.