The Costs and Benefits of Euro-sation in Central-Eastern Europe Before or Instead of EMU Membership

Countries unable or unwilling to join a Monetary Union can partly replicate membership effects through either a Currency Board or formal replacement of the domestic currency by the currency of the Union. Schemes of this kind have been introduced recently in Transition Economies. The net balance of costs and benefits involved, for the country and the common currency area, are shown to be an empirical question, depending on a number of conditions and primarily on the degree of monetary, real, and institutional convergence already achieved beforehand. Positive net advantages may derive from dollar/Euro-isation but should not be taken for granted.http://deepblue.lib.umich.edu/bitstream/2027.42/39724/3/wp340.pd

The Costs and Benefits of Euro-sation in Central-Eastern Europe Before or Instead of EMU Membership

Countries unable or unwilling to join a Monetary Union can partly replicate membership effects through either a Currency Board or formal replacement of the domestic currency by the currency of the Union. Schemes of this kind have been introduced recently in Transition Economies. The net balance of costs and benefits involved, for the country and the common currency area, are shown to be an empirical question, depending on a number of conditions and primarily on the degree of monetary, real, and institutional convergence already achieved beforehand. Positive net advantages may derive from dollar/Euro-isation but should not be taken for granted.Euro, monetary union, dollarisation, exchange rate regimes, convergence, transition

Using patient-reported measures to drive change in healthcare: the experience of the digital, continuous and systematic PREMs observatory in Italy

BACKGROUND: The use of Patient Reported Experience Measures (PREMs) has great potential in healthcare service improvement, but a limited use. This paper presents an empirical case of PREMs innovation in Italy, to foster patient data use up to the ward level, by keeping strengths and addressing weaknesses of previous PREMs survey experiences. The paper reports key lessons learned in this ongoing experience of action research, directly involving practitioners. METHODS: The aim of this paper is to present the results of an ongoing action research, encompassing the innovation of PREMs collection, reporting and use, currently adopted by 21 hospitals of two Italian regions. The continuous and systematic PREMs collection has been implemented between 2017 and 2019 and includes: a continuous web-based administration, using web-services; an augmented and positive questionnaire matching standard closed-ended questions with narrative sections; the inclusion and benchmarking of patient data within a shared performance evaluation system; public disclosure of aggregated anonymized data; a multi-level and real-time web-platform for reporting PREMs to professionals. The action research was carried out with practitioners in a real-life and complex context. The authors used multiple data sources and methods: observations, feedback of practitioners, collected during several workshops and meetings, and analysis of preliminary data on the survey implementation. RESULTS: A continuous and systematic PREMs observatory was developed and adopted in two Italian regions. PREMs participation and response rates tend to increase over time, reaching stable percentages after the first months. Narrative feedback provide a 'positive narration' of episodes and behaviours that made the difference to patients and can inform quality improvement actions. Real-time reporting of quantitative and qualitative data is enabling a gratifying process of service improvement and people management at all the hospitals' levels. CONCLUSIONS: The PREMs presented in this paper has been recognized by healthcare professionals and managers as a strategic and positive tool for improving an actual use of PREMs at system and ward levels, by measuring and highlighting positive deviances, such as compassionate behaviours

Kornai: Shortage versus surplus economies

The economics of institutions and comparative systems owes an enormous debt to János Kornai. This was well exemplified by Kornai (2014a), offering a synthetic characterization of socialism and capitalism, respectively, as shortage and surplus economies. I was very fortunate, over the last fifty years, to have had many opportunities to meet him and to talk to him, and to discuss these issues directly with him. János can be very persuasive, and over the years I have somewhat converged towards his views, but in this essay, I am going to rehearse one residual major disagreement on the shortage economy, and three reservations on capitalism as the surplus economy which, after discovering from talking to him that he was in basic sympathy with them, I have downgraded to qualifications

An overview of carbohydrate-based carbonic anhydrase inhibitors

Carbonic anhydrases (CAs) are metalloenzymes responsible for the reversible hydration of carbon dioxide to bicarbonate, a fundamental reaction involved in various physiological and pathological processes. In the last decades, CAs have been considered as important drug targets for different pathologies such as glaucoma, epilepsy and cancer. The design of potent and selective inhibitors has been an outstanding goal leading to the discovery of new drugs. Among the different strategies developed to date, the design of carbohydrate-based CA inhibitors (CAIs) has emerged as a versatile tool in order to selectively target CAs. The insertion of a glycosyl moiety as a hydrophilic tail in sulfonamide, sulfenamide, sulfamate or coumarin scaffolds allowed the discovery of many different series of sugar-based CAIs, with relevant inhibitory results. This review will focus on carbohydrate-based CAIs developed so far, classifying them in glycosidic and glycoconjugated inhibitors based on the conjugation chemistry adopted

Developments in carbohydrate-based metzincin inhibitors

Matrix metalloproteinases (MMPs) and A disintegrin and Metalloproteinase (ADAMs) are zinc-dependent endopeptidases belonging to the metzincin superfamily. Upregulation of metzincin activity is a major feature in many serious pathologies such as cancer, inflammations, and infections. In the last decades, many classes of small molecules have been developed directed to inhibit these enzymes. The principal shortcomings that have hindered clinical development of metzincin inhibitors are low selectivity for the target enzyme, poor water solubility, and long-term toxicity. Over the last 15 years, a novel approach to improve solubility and bioavailability of metzincin inhibitors has been the synthesis of carbohydrate-based compounds. This strategy consists of linking a hydrophilic sugar moiety to an aromatic lipophilic scaffold. This review aims to describe the development of sugar-based and azasugar-based derivatives as metzincin inhibitors and their activity in several pathological models

IMPAβ: Incremental modal pushover analysis for bridges

In the present study, the incremental modal pushover analysis (IMPAβ), a pushover-based approach already proposed and applied to buildings by the same authors, was revised and proposed for bridges (IMPAβ). Pushover analysis considers the effects of higher modes on the structural response. Bridges are structurally very different from multi-story buildings, where multimodal pushover (MPA) has been developed and is currently used. In bridges, consideration for higher modes is often necessary: The responses of some structural elements of the bridge (e.g., piers) influence the overall bridge response. Therefore, the failure of these elements can determine the failure of the whole structure, even if they give a small contribution total base shear. Incremental dynamic analysis (IDA) requires input accelerograms for high intensities, which are rare in the databases, while scaling of generated accelerograms with a simple increment of the scaling acceleration is not appropriate. This fact renders IDA, which is by its nature time-consuming, not straightforward. On the contrary, the change of input spectrum required by IMPA is simple. IMPAβ also utilizes a simple complementary method coupled to MPA, to obtain bounds at very high seismic intensities. Finally, the two incremental methods based on static nonlinear and dynamic nonlinear analyses are compared

Sensitivity and specificity of mastoid vibration test in detection of effects of vestibular neuritis [Sensibilità e specificità del test della vibrazione mastoidea nella individuazione degli esiti della neurite vestibolare]

Aim of this study was to determine sensitivity and specificity of the mastoid vibration test in patients who had suffered an attack of vestibular neuritis. Results were compared with the caloric test and two bedside tests of vestibular function (head shaking test and head thrust test). Results are reported in 28 patients who had a residual vestibular deficit 6 months after acute neuritis and in 25 healthy subjects. Mastoid vibration nystagmus was evoked in 21 patients but not in controls. In these patients, mastoid vibration test had a sensitivity of 75% and specificity of 100%. Since one patient had inverted mastoid vibration nystagmus, specificity of identification on the pathological side was 95%. Sensitivity of the test increased with increasing severity of the vestibular lesion. Indeed, mastoid vibration nystagmus was induced in 93% of patients with caloric paralysis and in 58% of those with caloric paresis. Nystagmus could usually be modulated or elicited by stimulation of either mastoid. In the few patients in whom mastoid vibration nystagmus was elicited only from one side, or when there was a clear difference in intensity of the nystagmus induced on the two sides, the stimulated side was more often the affected side. Four patients still showed spontaneous nystagmus. The caloric test was abnormal in 26/28 patients (93%) with paralysis in 16 and paresis in 12; 71% of patients had a head shaking induced nystagmus: 64% had an asymmetrical response in head thrust test. In conclusion, mastoid vibration test was overall more sensitive than head thrust test. Mastoid vibration test was slightly less sensitive than head shaking test in patients with severe residual deficit and more sensitive in patients with partial deficit. Mastoid vibration test, a valid, low cost clinical screening test for rapid detection of asymmetrical vestibular function, does not cause patient discomfort. It is suggested that this test be included in the diagnostic workup of all patients with suspected vestibular dysfunction

Generation of non-synchronous accelerograms for evaluate the seismic bridge response, including local site amplification.

Non-synchronous seismic actions particularly affect the behaviour of infrastructures with significant longitudinal extension, as bridges, interacting with the soil at surface or below ground level. Some authors state that non synchronism may increase by a large amount the structural response. Several acceleration records relative to different points of the ground with different soil profiles at distances meaningful for bridge analyses, are not available in data banks. The objective of this work is the generation of arrays of asynchronous signals at different points in space, starting from natural accelerograms related to a given seismic event, to increase the number of the available data. The computer code GAS has been modified to use natural accelerograms. The procedure has been applied to a real case, L’Aquila main-shock, for which records in different points of the free field are known