The European Bus with a High Level of Service (BHLS): Concept and Practice

The paper discusses the respective American Bus Rapid Transit (BRT) and European Bus with a High Level of Service (BHLS) concepts comparing their approaches and implementation conditions. It describes the main BHLS characteristics and the gains in ridership findings for several case studies among European countries.BRT, BHLS, BHLS Characteristics, Implementation conditions, gains in ridership

The European Bus with a High Level of Service (BHLS): Concept and Practice

International audienceThe paper discusses the respective American Bus Rapid Transit (BRT) and European Bus with a High Level of Service (BHLS) concepts comparing their approaches and implementation conditions. It describes the main BHLS characteristics and the gains in ridership findings for several case studies among European countries

L'adaptation de l'offre de transports en commun aux territoires vécus : réflexions à partir du cas de l'aire urbaine

Du fait de l'étalement urbain et de la dissociation croissante entre les lieux de domicile et d'emploi, les villes étendent leurs aires d'influence. La notion d'aire urbaine, développée par l'Insee, est une façon de rendre compte de ce phénomène. Elle s'appuie sur les déplacements domicile/travail qui sont concentrés dans le temps et servent de base pour définir les besoins en infrastructures.L'objet du présent rapport est d'étudier la relation entre un « territoire vécu », l'aire urbaine et l'offre de transports publics mise en place. Il s'appuie sur les réflexions menées dans trois grandes agglomérations françaises : Lyon, Strasbourg et Nancy qui font l'objet de trois monographies en fin d'ouvrage.Après avoir analysé les relations entre PTU et aires urbaines, l'étude met en évidence différentes réflexions en cours pour relier les agglomérations à leur couronne péri urbaine. Les aspects techniques (tramway périurbain, tram-train, cars à haut niveau de service, desserte TER périurbain) et les aspects institutionnels(syndicat mixte, coopération dans le cadre de projets) sont abordés.L'étude s'intéresse ensuite à la pertinence d'adapter l'offre de transport à un territoire comme l'aire urbaine et replace le débat sur l'articulation entre transports et urbanisme

Buses with High Level Of Service (BHLS) – Operational, Regulatory And Contractual Dimensions

Buses with High Level of Service (BHLS) is an emerging term in Europe for higher quality bus services in urban areas, based on a combination of better operating environment, high quality vehicles, upgraded infrastructure, improved customer services, marketing, image and a systemic approach. BHLS is not the same product as Bus Rapid Transit (BRT), although there are many features in common. The primary objective of BHLS is to uplift the quality of the bus mode rather than to provide the mass transit function. Many European cities have extreme limitations in available road width, BHLS aims to get the maximum capacity and quality within the available space. This paper reports the findings of an EU COST Action on BHLS, which includes practitioners and researchers from 14 EU countries. It presents BHLS practice, a set of 5 Case Studies (France, Netherlands, Ireland, Spain and Sweden, and operational characteristics of BHLS systems in Europe. A review of procurement and contractual aspects indicates that BHLS has been implemented within existing regulations, procedures, contract structures and performance parameters. Information on the COST TU603 action on BHLS can be obtained at www.bhls.euInstitute of Transport and Logistics Studies. Faculty of Economics and Business. The University of Sydne

Cardiac troponin and skeletal muscle oxygenation in severe post-partum haemorrhage

International audienceIntroductionCardiac troponin has been shown to be elevated in one-half of the parturients admitted for post-partum haemorrhage. The purpose of the study was to assess whether increased cardiac troponin was associated with a simultaneous alteration in haemoglobin tissue oxygen saturation in peripheral muscles in post-partum haemorrhage.MethodsTissue haemoglobin oxygen saturation of thenar eminence muscle (StO2) was measured via near-infrared spectroscopy technology. Two sets of StO2 parameters (both isolated baseline and during forearm ischaemia-reperfusion tests) were collected at two time points: upon intensive care unit admission and prior to intensive care unit discharge. Comparisons were performed using Wilcoxon paired tests, and univariate associations were assessed using logistic regression model and Wald tests.ResultsThe 42 studied parturients, admitted for post-partum haemorrhage, had clinical and biological signs of severe blood loss. Initial cardiac troponin I was increased in 24/42 parturients (0.43 ± 0.60 μrg/l). All measured parameters of muscular haemoglobin oxygen saturation, including Srecovery, were also altered at admission and improved together with improved haemodynamics, when bleeding was controlled. Multivariate analysis showed that muscular Srecovery ConclusionsOur study confirmed the high incidence of increased cardiac troponin, and demonstrated the simultaneous impairment in the reserve of oxygen delivery to peripheral muscles in parturients admitted for severe post-partum haemorrhage

Human Septic Myopathy: Induction of Cyclooxygenase, Heme Oxygenase and Activation of the Ubiquitin Proteolytic Pathway

Background: Skeletal muscle failure and wasting are manifestations of sepsis in humans that leads to serious and prolonged complications. The authors investigated the role of the major proinflammatory and antiinflammatory pathways, namely the inducible isoforms cyclooxygenase (COX-2) and heme oxygenase (HO-1), and the ubiquitin proteolytic pathway in skeletal muscle of septic patients. Methods: Protein expression was detected by Western blot techniques. Muscle biopsies were taken from two muscle groups, rectus abdominis and vastus lateralis, of septic and control patients. Results: The study showed an increase in COX-2 and HO-1 proteins expression and an activation of the proteolytic ubiquitin pathway with a parallel increase in free ubiquitin and ubiquitinated proteins in skeletal muscle of septic but not of control patients. In addition, those patients who would die from septic shock expressed more COX-2 and HO-1 proteins in muscle biopsies than did those patients who would survive. Conclusions: This study showed a marked involvement of local proinflammatory and antiinflammatory pathways and, more importantly, demonstrated the existence of an active ubiquitin proteolytic pathway in skeletal muscle of septic patients. Activation of ubiquitin pathway could be involved in sepsis-related muscle catabolism and wasting

Exploratory study of consumer issues in online peer-to-peer platform markets: final report

This is a report published by the European Commission. For re-use please see the publisher's terms and conditions.This study explores consumer issues in five online peer to peer platform markets: (Re)sale of Goods; Sharing/renting of goods, Sharing/renting accommodation; Sharing/hiring rides; and Odd jobs. The study estimates that 191m citizens across the EU-28 spend EUR 27.9 billion per year on online P2P platforms. Of this total, an estimated EUR 10.61 billion consists of platform revenues and revenues of third parties. The study defines three main peer-to-peer platform business models: (a) hosting of listings where platforms do not get involved in the peer to peer transaction (b) active management of transactions where platforms foster trust among peers to facilitate a larger number of transactions and (c) platform governed peer transactions where the platform sets one or more contractual terms for the peer-to-peer transaction and exercises control over the performance of the transaction. The study identifies five key consumer issues that emerge from this new kind of economy: (1) transparency and clarity regarding the nature of transactions concluded through online P2P platforms, applicable consumer rights and obligations, the applicable legal framework and its enforcement; (2) reliability of peer review and rating systems and accuracy of identity information provided on the platform; (3) discrepancy between exclusion of platform responsibility and liability for the performance of online P2P transactions and platform practices; (4) access to redress for peer consumers and peer providers; and (5) data use and data protection issues.This report was produced under the EU Consumer Programme (2014-2020) in the frame of a service contract with the Consumers, Health, Agriculture and Food Executive Agency (Chafea) acting under the mandate from the European Commission.Published versio

Intensive care unit—acquired weakness (ICUAW) and muscle wasting in critically ill patients with severe sepsis and septic shock

Sepsis presents a major health care problem and remains one of the leading causes of death within the intensive care unit (ICU). Therapeutic approaches against severe sepsis and septic shock focus on early identification. Adequate source control, administration of antibiotics, preload optimization by fluid resuscitation and further hemodynamic stabilisation using vasopressors whenever appropriate are considered pivotal within the early—golden—hours of sepsis. However, organ dysfunction develops frequently in and represents a significant comorbidity of sepsis. A considerable amount of patients with sepsis will show signs of severe muscle wasting and/or ICU-acquired weakness (ICUAW), which describes a frequently observed complication in critically ill patients and refers to clinically weak ICU patients in whom there is no plausible aetiology other than critical illness. Some authors consider ICUAW as neuromuscular organ failure, caused by dysfunction of the motor unit, which consists of peripheral nerve, neuromuscular junction and skeletal muscle fibre. Electrophysiologic and/or biopsy studies facilitate further subclassification of ICUAW as critical illness myopathy, critical illness polyneuropathy or critical illness myoneuropathy, their combination. ICUAW may protract weaning from mechanical ventilation and impede rehabilitation measures, resulting in increased morbidity and mortality. This review provides an insight on the available literature on sepsis-mediated muscle wasting, ICUAW and their potential pathomechanisms