Monetary Policy and Large Crises in a Financial Accelerator Agent-Based Model

An accommodating monetary policy followed by a sudden increase of the short term interest rate often leads to a bubble burst and to an economic slowdown. Two examples are the Great Depression of 1929 and the Great Recession of 2008. Through the implementation of an Agent Based Model with a financial accelerator mechanism we are able to study the relationship between monetary policy and large scale crisis events. The main results can be summarized as follow: a) sudden and sharp increases of the policy rate can generate recessions; b) after a crisis, returning too soon and too quickly to a normal monetary policy regime can generate a "double dip" recession, while c) keeping the short term interest rate anchored to the zero lower bound in the short run can successfully avoid a further slowdown

Metabolic and cardiovascular improvements after biliopancreatic diversion in a severely obese patient

BACKGROUND: Severe obesity is associated with important morbidity and increased mortality. The successes of lifestyle modifications and drug therapy have been partial and mostly unsustained in reducing obesity and its comorbidities. Bariatric surgery, particularly biliopancreatic diversion with duodenal switch reduces efficiently excess body weight and improves metabolic and cardiovascular functions. CASE PRESENTATION: A 56-year-old man with severe clinical obesity underwent a biliopancreatic diversion with a duodenal switch after unsuccessful treatment with weight loss pharmacotherapy. He had diabetes, hypertension and sleep apnea syndrome and was on three medications for hypertension and two hypoglycemic agents in addition to > 200 insulin units daily. Eleven months after the surgery, he had lost 40% of his body weight. The lipid profile showed great improvement and the hypertension and diabetes were more easily controlled with no more insulin needed. The pseudonormalized pattern of left ventricular diastolic function improved and ventricular walls showed decreased thickness. CONCLUSION: Biliopancreatic diversion may bring metabolic and cardiovascular benefits in severely obese patients from a cardiovascular perspective

Overview of the current use of levosimendan in France: a prospective observational cohort study

Abstract Background Following the results of randomized controlled trials on levosimendan, French health authorities requested an update of the current use and side-effects of this medication on a national scale. Method The France-LEVO registry was a prospective observational cohort study reflecting the indications, dosing regimens, and side-effects of levosimendan, as well as patient outcomes over a year. Results The patients included ( n = 602) represented 29.6% of the national yearly use of levosimendan in France. They were treated for cardiogenic shock ( n = 250, 41.5%), decompensated heart failure ( n = 127, 21.1%), cardiac surgery-related low cardiac output prophylaxis and/or treatment ( n = 86, 14.3%), and weaning from veno-arterial extracorporeal membrane oxygenation ( n = 82, 13.6%). They received 0.18 ± 0.07 µg/kg/min levosimendan over 26 ± 8 h. An initial bolus was administered in 45 patients (7.5%), 103 (17.1%) received repeated infusions, and 461 (76.6%) received inotropes and or vasoactive agents concomitantly. Hypotension was reported in 218 patients (36.2%), atrial fibrillation in 85 (14.1%), and serious adverse events in 17 (2.8%). 136 patients (22.6%) died in hospital, and 26 (4.3%) during the 90-day follow-up. Conclusions We observed that levosimendan was used in accordance with recent recommendations by French physicians. Hypotension and atrial fibrillation remained the most frequent side-effects, while serious adverse event potentially attributable to levosimendan were infrequent. The results suggest that this medication was safe and potentially associated with some benefit in the population studied

La Bandelette sous-urétrale T.V.T (Tension-free-Vaginale Tape)

REIMS-BU Santé (514542104) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Nouvelles mentions de trois espèces de Cleridae (Coleoptera) pour le Québec

Les auteurs rapportent la présence au Québec de trois espèces de Cleridae (Coleoptera) jusqu’ici non répertoriées pour cette province : Enoclerus ichneumoneus (Fabricius, 1777) (sous-famille : Clerinae Latreille, 1802), Monophylla terminata (Say, 1835) (sous-famille : Tillinae Fischer von Waldheim, 1813) et Pyticeroides laticornis (Say, 1835) (sous-famille : Korynetinae Laporte, 1836). Ils incluent aussi les données de capture ainsi que des informations provenant de la littérature sur leur répartition géographique et leur biologie.Three species of Cleridae (Coleoptera) are reported for the first time from the province of Quebec (Canada): Enoclerus ichneumoneus (Fabricius, 1777) (subfamily: Clerinae Latreille, 1802); Monophylla terminata (Say, 1835) (subfamily: Tillinae Fischer von Waldheim, 1813); and Pyticeroides laticornis (Say, 1835) (subfamily: Korynetinae Laporte, 1836). Collection notes are included along with information from the literature concerning their biology and known geographical distribution

Le travail d’accompagnement des formateurs de stagiaires en enseignement supérieur : plusieurs regards pour le comprendre et l’outiller

Introduction d'un numéro spécial de Phronesis Le rôle des programmes de formations supérieures professionnalisantes et les apports formatifs constitutifs a priori des milieux de stages reposent sur un juste équilibre entre divers facteurs qui conditionnent la qualité de la préparation à une profession. L’acquisition des savoirs professionnels et le développement des compétences ne peuvent se jouer totalement dans des structures externes au monde du travail ou dans les centres de formation. L’alternance entre ces deux milieux est au service du développement d’une véritable articulation théorie-pratique permettant aux étudiants , d’une part, d’investir les savoirs théoriques et procéduraux issus de la formation sur le terrain et, d’autre part, de formaliser les savoirs pratiques acquis sur le terrain en situation réelle (Chaubet, Leroux, Masson, Gervais, & Malo, 2018 ; Perrenoud, Altet, Lessard & Paquay, 2008)

Assessment of team training in management of adverse acute events occurring during cardiopulmonary bypass procedure: a pilot study based on an animal simulation model (Fouilloux, Team training in cardiac surgery)

Successful cardiac surgery is highly dependent upon effective and efficient teamwork. Practical training and development will further enhance the team ability to react to a series of low-frequency occurring adverse events during cardiopulmonary bypass (CPB). One of our specialized educational programs focuses on training the whole team. This training is based on an original animal simulation model. The objective of this pilot study was to assess our method of training and learning in an attempt to optimize and improve team management and functioning. Methods: Four members of the same cardiac surgery team joined our program. They performed a common procedure, with a cardiopulmonary bypass (CPB) circuit set up to produce several adverse incidents. Events management was ana¬lyzed and debriefed in technical and non-technical perspectives. Results: Management of the adverse events was significantly improved. Discussion and debriefing time was fundamental in identifying the most appropriate management for each event. Rescue procedures were assimilated and team training was found to be effective, with the time reduced by up to 50% for 3 events and by up to 70% for air embolism. Conclusion: Our pilot program is an innovative, low-cost tool for the improvement of the management of adverse events occurring during CPB. It includes the different components of surgical education and training. Such an educational tool might be relevant for training. To confirm those encouraging results, it should be assessed in a larger surgical team panel. Further investigations are required for assessing efficiency in real conditions

COST BENEFIT ANALYSIS OF ENERGY BOXES DEPLOYMENT IN HOUSEHOLDS IN EUROPE: IMPACT OF THE SPOT PRICES

International audienceThe present paper presents a study willing to assess theprofitability of replacing a conventional thermostat by aSmartelectricreplacement is a prerequisite for a dweller to take theentire advantage of a subscription at Real Time Price(RTP) tariffs. A deterministic model hasDayend of 2014 for Denmark, Norway, Finland, Sweden,Estonia, Latvia and Lithuania. It computes these datawith hourly outside temperature series of one uniqueweather station (Malmö) into a theoreticalThe model enables to get load profiles and annual energybill. The dweller welfare modification is finally shortlyanalysedsimulated bills and a benchmark of the Smart Thermostatavailable on the marthat the profitability for the endhighly dependent of the national power market context