L'état des communes dans le canton de Vaud

Les communes vaudoises ne sont pas épargnées par les profonds changements que subissent les communes suisses depuis les années 90. Le nombre de réformes a augmenté de manière considérable et les causes de ces changements sont multiples: une complexité croissante des prestations à fournir, la recherche de formes organisationnelles plus efficaces, la difficulté de trouver des personnes s'engageant en politique. Vu ces défis, la fusion de communes a été fréquente dans certains cantons. Quant à lui, le canton de Vaud reste un canton avec un grand nombre de communes de petite taille. C'est entre autre sous l'aspect de la différente taille des communes que cette étude aborde des thèmes concernant les communes vaudoises, comme par exemple les limites de performances des communes, la politique et l'administration communale, les relations et la répartition des tâches entre les communes et le canton, la collaboration intercommunale où encore les fusions de communes. L'analyse se base sur les données de l'enquête auprès des secrétaires communaux suisses qui a lieu régulièrement depuis 1988

Impact of cardiac magnetic resonance imaging on human lymphocyte DNA integrity

Aims Magnetic resonance (MR) imaging is widely used for diagnostic imaging in medicine as it is considered a safe alternative to ionizing radiation-based techniques. Recent reports on potential genotoxic effects of strong and fast switching electromagnetic gradients such as used in cardiac MR (CMR) have raised safety concerns. The aim of this study was to analyse DNA double-strand breaks (DSBs) in human blood lymphocytes before and after CMR examination. Methods and results In 20 prospectively enrolled patients, peripheral venous blood was drawn before and after 1.5 T CMR scanning. After density gradient cell separation of blood samples, DNA DSBs in lymphocytes were quantified using immunofluorescence microscopy and flow cytometric analysis. Wilcoxon signed-rank testing was used for statistical analysis. Immunofluorescence microscopic and flow cytometric analysis revealed a significant increase in median numbers of DNA DSBs in lymphocytes induced by routine 1.5 T CMR examination. Conclusion The present findings indicate that CMR should be used with caution and that similar restrictions may apply as for X-ray-based and nuclear imaging techniques in order to avoid unnecessary damage of DNA integrity with potential carcinogenic effec

Towards global sustainability: Education on environmentally clean energy technologies

The recent climate change agreement in Paris highlights the imperative to aggressively decarbonize the energy economy and develop new technologies, especially for the generation of electrical energy that are environmentally clean. This challenge can only be addressed by a multi-pronged approach to research and education of the next generation of scientists and engineers as well as informed public discourse. Consequently this requires the introduction of new and comprehensive education programs on sustainable energy technologies for universities and, possibly, high schools. Among others, the new programs should provide in-depth knowledge in the development of new materials for more efficient energy conversion systems and devices. The enhanced level of education is also needed for properly assessing the competing technologies in terms of their economic and social benefits. The increasing recognition of the significance of clean and efficient energy conversion indicates the need for a comprehensive education program to be developed. The purpose of the present work is to consider the structure of both an education program and the related textbook where the energy-related fundamental and applied subjects are presented in a concentrated and uniform manner. Such a textbook could be an education aid for students of energy-related courses as well as the teachers involved in the formulation of the education programs. The textbook, which should be dedicated mainly for students at the undergraduate levels at universities, and possibly high schools, should include in-depth interdisciplinary sections dedicated to energy experts and graduate students. This paper considers the present international efforts in reducing the impact of climate change and the need to develop new technologies for clean energy generation. It is argued that progress in this area requires recognition of hydrogen as the main energy carrier of the future. This work also delineates the goals of the Sustainable Energy Network, SEN, involved in the UN program of Future Earth

Prognostic value of cardiac hybrid imaging integrating single-photon emission computed tomography with coronary computed tomography angiography

Aims Although cardiac hybrid imaging, fusing single-photon emission computed tomography (SPECT) myocardial perfusion imaging with coronary computed tomography angiography (CCTA), provides important complementary diagnostic information for coronary artery disease (CAD) assessment, no prognostic data exist on the predictive value of cardiac hybrid imaging. Hence, the aim of this study was to assess the prognostic value of hybrid SPECT/CCTA images. Methods and results Of 335 consecutive patients undergoing a 1-day stress/rest 99mTc-tetrofosmin SPECT and a CCTA, acquired on stand-alone scanners and fused to obtain cardiac hybrid images, follow-up was obtained in 324 patients (97%). Survival free of all-cause death or non-fatal myocardial infarction (MI) and free of major adverse cardiac events (MACE: death, MI, unstable angina requiring hospitalization, coronary revascularizations) was determined using the Kaplan-Meier method for the following groups: (i) stenosis by CCTA and matching reversible SPECT defect; (ii) unmatched CCTA and SPECT finding; and (iii) normal finding by CCTA and SPECT. Cox's proportional hazard regression was used to identify independent predictors for cardiac events. At a median follow-up of 2.8 years (25th-75th percentile: 1.9-3.6), 69 MACE occurred in 47 patients, including 20 death/MI. A corresponding matched hybrid image finding was associated with a significantly higher death/MI incidence (P < 0.005) and proved to be an independent predictor for MACE. The annual death/MI rate was 6.0, 2.8, and 1.3% for patients with matched, unmatched, and normal findings. Conclusion Cardiac hybrid imaging allows risk stratification in patients with known or suspected CAD. A matched defect on hybrid image is a strong predictor of MAC

Inter-scan variability of coronary artery calcium scoring assessed on 64-multidetector computed tomography vs. dual-source computed tomography: a head-to-head comparison

Aims Coronary artery calcium (CAC) scoring has emerged as a tool for risk stratification and potentially for monitoring response to risk factor modification. Therefore, repeat measurements should provide robust results and low inter-scanner variability for allowing meaningful comparison. The purpose of this study was to investigate inter-scanner variability of CAC for Agatston, volume, and mass scores by head-to-head comparison using two different cardiac computed tomography scanners: 64-detector multislice CT (MSCT) and 64-slice dual-source CT (DSCT). Methods and results Thirty patients underwent CAC measurements on both 64-MSCT (GE LightSpeed XT scanner: 120 kV, 70 mAs, 2.5 mm slices) and 64-DSCT (Siemens Somatom Definition: 120 kV, 80 mAs, 3 mm slices) within <100 days (0-97). Retrospective intra-scan comparison revealed an excellent correlation. The excellent intra-scan (inter-observer) agreement was documented by narrow limits of agreement and a correlation coefficient of variation (COV) of r ≥ 0.99 (P < 0.001) for all CAC scores with a low COV for both scanners (64-MSCT/64-DSCT), i.e. Agatston (2.0/2.1%), mass (3.0/2.0%), and volume (4.7/3.9%). Inter-scanner comparison revealed larger Bland-Altman (BA) limits of agreement, despite high correlation (r ≥ 0.97) for all scores, with COV at 15.1, 21.6, and 44.9% for Agatston, mass, and volume scores. The largest BA limits were observed for volume scores (−1552.8 to 574.2), which was massively improved (−241.0 to 300.4, COV 11.5%) after reanalysing the 64-DSCT scans (Siemens) with GE software/workstation (while Siemens software/workstation does not allow cross-vendor analysis). Phantom measurements confirmed overestimation of volume scores by ‘syngo Ca-Scoring' (Siemens) software which should therefore be reviewed (vendor has been notified). Conclusion Intra- and inter-scan agreement of CAC measurement in a given data set is excellent. Inter-scanner variability is reasonable, particularly for Agatston units in the clinically most relevant range <1000. The use of different software solutions has a greater influence particularly on volume scores than the use of different scanner type

Coastal Ocean Forecasting: science foundation and user benefits

The advancement of Coastal Ocean Forecasting Systems (COFS) requires the support of continuous scientific progress addressing: (a) the primary mechanisms driving coastal circulation; (b) methods to achieve fully integrated coastal systems (observations and models), that are dynamically embedded in larger scale systems; and (c) methods to adequately represent air-sea and biophysical interactions. Issues of downscaling, data assimilation, atmosphere-wave-ocean couplings and ecosystem dynamics in the coastal ocean are discussed. These science topics are fundamental for successful COFS, which are connected to evolving downstream applications, dictated by the socioeconomic needs of rapidly increasing coastal populations