Deconstructing economic, ecologic and social urban discourses for innovation policies

Worldwide, cities are called upon to help achieve a wide variety of policy goals, varying from economic growth, increased energy efficiency and the mitigation of global warming, to improving the liveability of urban neighbourhoods and the active participation of the population in urban planning. In particular, cities are supposed to help achieve necessary innovations in these domains. Both local governments (municipalities) and regional alliances of local governments (in metropolitan areas) are thought to have a thorough insight into relevant local and regional circumstances, are supposed to be able to act relatively quickly and decisively, and are thought to be able experimenters. This paper acknowledges that a growing number of (larger) cities present ambitious policy plans and take effective action in the (combined) fields of economic growth, the mitigation of climate change, and improving liveability and sociale inclusion in urban neighhourhoods. However, it also acknoweldges that there are limits to the capacities of cities to help achieve innovations, think of cities’ limited abilities to change established large-scale systems in the field of energy production. The following central question is addressed: Under which conditions are (cooperating) cities able to plan and act quickly and decisively, learn from local experiments, and share insights across national borders and sectoral domains? This question is approached by performing a discourse analysis of the relevant scholarly literature and policies and plans regarding the roles of cities in innovation processes in the combined fields introduced above. The paper takes the current debate in the Netherlands as a starting point, considering it in the context of related debates in the international arena

Smart, Green and Inclusive Urban Growth: Visualising Recent Developments in European Cities

Cities are expected to play a key role in delivering the Europe 2020 strategy for smart, green and inclusive growth. Concerning smart growth, cities are at the forefront of innovation. Moreover, the physical concentration of people, capital and business opportunities means that cities are more productive than other places. In relation to green growth, healthy, compact and energy-efficient cities are key to achieving sustainability in Europe. Many European cities are currently developing or expanding their networks for walking, cycling, public transport, waste management, district heating and green infrastructures. Finally, cities can contribute to inclusive growth. For example, by combating social polarisation and poverty, by providing affordable housing and by integrating refugees and migrants. In the context of the Urban Agenda for the EU and the Dutch EU presidency in the first half of 2016, the PBL Netherlands Environmental Assessment Agency has recently published ‘Cities in Europe’ (PBL, 2016), a publication that visualises facts and figures concerning recent urban developments in relationship to smart, green and inclusive growth in the European Union. Based on the harmonised definition of urban areas by Eurostat and the OECD (OECD, 2012), European cities are compared with each other and recent trends are described, such as those in migration, risk of urban poverty and urban-rural divergence in employment growth. Furthermore, the following questions are being explored: which cities have shown strong growth in population, GDP and employment? Are the growth rates related to the size of the agglomerations? In which cities is the population showing high levels of satisfaction about quality of life? And which cities are falling behind? What types of territorial patterns can be distinguished? This paper summarises the main findings of the publication and presents a number of infographics that give insight into the scale, dimension and relationships of urban developments in Europe

Quantitative Validation: An Overview and Framework for PD Backtesting and Benchmarking.

The aim of credit risk models is to identify and quantify future outcomes of a set of risk measurements. In other words, the model's purpose is to provide as good an approximation as possible of what constitutes the true underlying risk relationship between a set of inputs and a target variable. These parameters are used for regulatory capital calculations to determine the capital needed that serves a buffer to protect depositors in adverse economic conditions. In order to manage model risk, financial institutions need to set up validation processes so as to monitor the quality of the models on an ongoing basis. Validation is important to inform all stakeholders (e.g. board of directors, senior management, regulators, investors, borrowers, …) and as such allow them to make better decisions. Validation can be considered from both a quantitative and qualitative point of view. Backtesting and benchmarking are key quantitative validation tools. In backtesting, the predicted risk measurements (PD, LGD, CCF) will be contrasted with observed measurements using a workbench of available test statistics to evaluate the calibration, discrimination and stability of the model. A timely detection of reduced performance is crucial since it directly impacts profitability and risk management strategies. The aim of benchmarking is to compare internal risk measurements with external risk measurements so to allow to better gauge the quality of the internal rating system. This paper will focus on the quantitative PD validation process within a Basel II context. We will set forth a traffic light indicator approach that employs all relevant statistical tests to quantitatively validate the used PD model, and document this complete approach with a reallife case-study.Framework; Benchmarking; Credit; Credit scoring; Control;

Charge Dynamics at the Silicon(001) Surface Studied by Scanning Tunneling Microscopy and Surface Photovoltage

Scanning tunneling microscopy measurements of local surface photovoltage of the Si(001) surface reveal the existence of local charging produced by the tunneling current. Since the tunneling current is confined to a region of near atomic dimensions, charge transport between surface and bulk electronic states is probed with high spatial resolution. The surface charge is enhanced while tunneling at the bonded, type-B atomic step and at specific point defects demonstrating atomic-scale variations in the charge dynamics

The rural-urban fringe in the Netherlands: recent developments and future challenges

In recent decades, most rural-urban fringes in the Netherlands have seen substantial urbanisation. Urban expansions at the rural-urban fringe have formed complex hybrid landscapes consisting of residential areas, commercial zones, agricultural land, recreational and nature areas. In certain regions, urbanisation is rather compact and concentric, whereas others show dispersed and polycentric morphological patterns. Based on quantitative and qualitative spatial research, this article analyses recent urban developments and urbanisation patterns along the rural-urban fringe in the Netherlands, and identifies challenges for planning and design at national, regional and local levels.Urban compaction policy has prevented urban sprawl in the Netherlands. However, in some regions traditionally unwanted urban development patterns can be discerned. On a national level, an important question is how increasing dispersed urbanisation may affect the economic performance of cities and the efficient use of existing infrastructure. On a regional level, there is a need for urbanisation strategies that transcend municipal boundaries. On a local level, innovative urban design/re-design strategies may help improve connections between separated functions, involve local stakeholders, and upgrade the identity of places at the fringe

Increasing the use of second-line therapy is a cost-effective approach to prevent the spread of drug-resistant HIV: a mathematical modelling study

METHODS: We develop a deterministic mathematical model representing Kampala, Uganda, to predict the prevalence of TDR over a 10-year period. We then compare the impact on TDR and cost-effectiveness of: (1) introduction of pre-therapy genotyping; (2) doubling use of second-line treatment to 80% (50-90%) of patients with confirmed virological failure on first-line ART; and (3) increasing viral load monitoring from yearly to twice yearly. An intervention can be considered cost-effective if it costs less than three times the gross domestic product per capita per quality adjusted life year (QALY) gained, or less than $3420 in Uganda.RESULTS: The prevalence of TDR is predicted to rise from 6.7$1612 to $2234 (IQR$450-dominated) per QALY gained.CONCLUSIONS: While earlier treatment initiation will result in a predicted increase in the proportion of patients infected with drug-resistant HIV, the absolute numbers of patients infected with drug-resistant HIV is predicted to decrease. Increasing use of second-line treatment to all patients with confirmed failure on first-line therapy is a cost-effective approach to reduce TDR. Improving access to second-line ART is therefore a major priority.INTRODUCTION: Earlier antiretroviral therapy (ART) initiation reduces HIV-1 incidence. This benefit may be offset by increased transmitted drug resistance (TDR), which could limit future HIV treatment options. We analyze the epidemiological impact and cost-effectiveness of strategies to reduce TDR

Nuclear receptors in vascular biology

Nuclear receptors sense a wide range of steroids and hormones (estrogens, progesterone, androgens, glucocorticoid, and mineralocorticoid), vitamins (A and D), lipid metabolites, carbohydrates, and xenobiotics. In response to these diverse but critically important mediators, nuclear receptors regulate the homeostatic control of lipids, carbohydrate, cholesterol, and xenobiotic drug metabolism, inflammation, cell differentiation and development, including vascular development. The nuclear receptor family is one of the most important groups of signaling molecules in the body and as such represent some of the most important established and emerging clinical and therapeutic targets. This review will highlight some of the recent trends in nuclear receptor biology related to vascular biology

Phenotype of ARDS alveolar and blood neutrophils

RATIONALE: Acute respiratory distress syndrome is refractory to pharmacological intervention. Inappropriate activation of alveolar neutrophils is believed to underpin this disease's complex pathophysiology, yet these cells have been little studied. OBJECTIVES: To examine the functional and transcriptional profiles of patient blood and alveolar neutrophils compared with healthy volunteer cells, and to define their sensitivity to phosphoinositide 3-kinase inhibition. METHODS: Twenty-three ventilated patients underwent bronchoalveolar lavage. Alveolar and blood neutrophil apoptosis, phagocytosis, and adhesion molecules were quantified by flow cytometry, and oxidase responses were quantified by chemiluminescence. Cytokine and transcriptional profiling were used in multiplex and GeneChip arrays. MEASUREMENTS AND MAIN RESULTS: Patient blood and alveolar neutrophils were distinct from healthy circulating cells, with increased CD11b and reduced CD62L expression, delayed constitutive apoptosis, and primed oxidase responses. Incubating control cells with disease bronchoalveolar lavage recapitulated the aberrant functional phenotype, and this could be reversed by phosphoinositide 3-kinase inhibitors. In contrast, the prosurvival phenotype of patient cells was resistant to phosphoinositide 3-kinase inhibition. RNA transcriptomic analysis revealed modified immune, cytoskeletal, and cell death pathways in patient cells, aligning closely to sepsis and burns datasets but not to phosphoinositide 3-kinase signatures. CONCLUSIONS: Acute respiratory distress syndrome blood and alveolar neutrophils display a distinct primed prosurvival profile and transcriptional signature. The enhanced respiratory burst was phosphoinositide 3-kinase-dependent but delayed apoptosis and the altered transcriptional profile were not. These unexpected findings cast doubt over the utility of phosphoinositide 3-kinase inhibition in acute respiratory distress syndrome and highlight the importance of evaluating novel therapeutic strategies in patient-derived cells.This work was funded by a non-commercial grant from GSK, with additional support from The Wellcome Trust, Papworth Hospital, The British Lung Foundation and the NIHR Cambridge Biomedical Research Centre. DMLS holds a Gates Cambridge Scholarship; CS is in receipt of a Wellcome Trust Early Postdoctoral Research Fellowship for Clinician Scientists [WT101692MA].This is the author accepted manuscript. The final version is available from ATS Journals via http://dx.doi.org/10.1164/rccm.201509-1818O

A European study investigating patterns of transition from home care towards institutional dementia care: the protocol of a RightTimePlaceCare study

<p>Abstract</p> <p>Background</p> <p>Health care policies in many countries aim to enable people with dementia to live in their own homes as long as possible. However, at some point during the disease the needs of a significant number of people with dementia cannot be appropriately met at home and institutional care is required. Evidence as to best practice strategies enabling people with dementia to live at home as long as possible and also identifying the right time to trigger admission to a long-term nursing care facility is therefore urgently required. The current paper presents the rationale and methods of a study generating primary data for best-practice development in the transition from home towards institutional nursing care for people with dementia and their informal caregivers. The study has two main objectives: 1) investigate country-specific factors influencing institutionalization and 2) investigate the circumstances of people with dementia and their informal caregivers in eight European countries. Additionally, data for economic evaluation purposes are being collected.</p> <p>Methods/design</p> <p>This paper describes a prospective study, conducted in eight European countries (Estonia, Finland, France, Germany, Netherlands, Sweden, Spain, United Kingdom). A baseline assessment and follow-up measurement after 3 months will be performed. Two groups of people with dementia and their informal caregivers will be included: 1) newly admitted to institutional long-term nursing care facilities; and 2) receiving professional long-term home care, and being at risk for institutionalization. Data will be collected on outcomes for people with dementia (e.g. quality of life, quality of care), informal caregivers (e.g. caregiver burden, quality of life) and costs (e.g. resource utilization). Statistical analyses consist of descriptive and multivariate regression techniques and cross-country comparisons.</p> <p>Discussion</p> <p>The current study, which is part of a large European project 'RightTimePlaceCare', generates primary data on outcomes and costs of long-term nursing care for people with dementia and their informal caregivers, specifically focusing on the transition from home towards institutional care. Together with data collected in three other work packages, knowledge gathered in this study will be used to inform and empower patients, professionals, policy and related decision makers to manage and improve health and social dementia care services.</p