Embracing Allied Approaches to Public Health: Luxembourg's Industrial Elites and the Rockefeller Mission against Tuberculosis in France after the First World War.

The Rockefeller Commission for the Prevention of Tuberculosis in France played a key role in public health reforms in post-World War I France. In May 1920, one of the commission's traveling units whose goal was to bring health education to the French departments toured the Grand-Duchy of Luxembourg. This article discusses this ten-day campaign as a trigger for comprehensive public health reforms in Luxembourg. By the 1920s the steel industry had become the country's dominant economic sector, with the conglomerate Arbed as the main employer in constant need of a healthy workforce. A group of Luxembourgian anti-tuberculosis activists, spearheaded by the wife of the country's foremost industrialist, tried to benefit from the Rockefeller projects in France. Throughout the following decades, Luxembourgian anti-tuberculosis activists maintained close contacts with French experts. This article traces the transnational circulation of public health knowledge in the interwar period and elucidates Luxembourg's geostrategic repositioning after World War I.

Marginal ulcers after laparoscopic Roux-en-Y gastric bypass: analysis of the amount of daily and lifetime smoking on postoperative risk.

BACKGROUND: A common postoperative complication after laparoscopic Roux-en-Y gastric bypass (LRYGB) is the development of marginal ulcers (MUs) at the gastrojejunal anastomosis. Several risk factors, such as smoking, seem to have an impact on the development of MUs. OBJECTIVE: Very little is known about how much smoking increases the risk. We therefore reviewed our patients regarding their smoking behavior and the development of MUs after LRYGB. SETTING: Primary care hospital and a university hospital. METHODS: This study included 249 patients who underwent LRYGB surgery between 2010 and 2015 with at least 2 years of follow-up at a single institution. This retrospective analysis focused on the development of marginal ulcers after LRYGB, the time of appearance, and possible risk factors. RESULTS: A total of 27 (10.8%) patients in this study developed MUs. The majority of MUs (66.7%) occurred within the first postoperative year. Smoking is an independent and statistically significant predictor of the development of MUs with a 4.6-fold greater risk (P = .003). Light, moderate, and heavy daily smokers have the same rate of MUs (17.4% versus 17.1% versus 17.9%, respectively). Light smokers with <10 cigarettes per day are at significantly increased risk for MUs compared with nonsmokers (17.4 versus 4.2%, respectively; P = .027). Former and current smokers are at comparable risks for MUs (13.3% versus 17.5%, respectively; P = .685). CONCLUSION: The described incidence of 10.8% shows that marginal ulcers are one of the most important and frequent complications after LRYGB. Smoking at every intensity is associated with an extraordinary risk of MU formation after LRYGB and therefore, smoking cessation before bariatric surgery must be strongly recommended.

3D detection of periodic limb movements in sleep.

The standard polysomnographic method for detecting periodic limb movements in sleep (PLMS) includes measuring the electromyography (EMG) signals from electrodes at the left and right tibialis anterior muscles. This procedure has disadvantages as the cabling affects the patients quality of sleep and the electrodes tend to come off during the night, deteriorating data quality. We used contactless monitoring of body movements by a 3D time-of-flight camera mounted above the bed. Changes in the 3D silhouette indicate motion. Contactless detection of PLMS has several substantial advantages over the EMG and provides more complete and more specific diagnostic data: (1) Motor events caused by other leg muscles than tibialis anterior muscles are fully captured by the 3D method, but missed by EMG. (2) 3D does not react to tonic muscle contractions, where such contractions cause strong deflections in EMG which are annotated as limb movements by most PSG apparatus. Another aspect turned out to be of high practical relevance: Deflections in EMG traces are frequently caused by poor electrode contacts, potentially causing false movement annotations. This can lead to substantial overestimation of the automatically computed PLM index. Contactless sensing completely avoids such problems.