Cross-border metropolitan integration in Europe (Luxembourg, Basel and Geneva)

This article questions the integration processes in three small cross-border metropolitan areas: Luxembourg, Basel and Geneva. By referring to an original analysis framework, it evaluates the nature and intensity of the functional and institutional integration and highlights the elements that structure the cooperation between the actors. The analysis shows that there is not necessarily a reciprocal link between the size of the functional area and the extent of the cooperation. Whilst no metropolitan-sized project is on the agenda in Luxembourg, the example of Basel and Geneva shows that the presence of a national border offers an opportunity to invent original forms of governance, increase the autonomy of the local authorities by different types of cooperation which transcend the institutional and territorial divides, and enable the international character of the metropolitan centre to be valued for what it is. In a context of global competition, these features represent an undeniable benefit.Metropolitan regions ; Governance ; Border studies ; Integration ; Europe

Target Zones in History and Theory: Lessons from an Austro-Hungarian Experiment (1896-1914)

The first known experiment with an exchange rate band took place in Austria- Hungary between 1896 and 1914. The rationale for introducing this policy rested on precisely those intuitions that the modern literature has emphasized: the band was designed to secure both exchange rate stability and monetary policy autonomy. However, unlike more recent experiences, such as the ERM, this policy was not undermined by credibility problems. The episode provides an ideal testing ground for some important ideas in modern macroeconomics: specifically, can formal rules, when faithfully adhered to, provide policy makers with some advantages such as short term autonomy? First, we find that a credible band has a "microeconomic" influence on exchange rate stability. By reducing uncertainty, a credible fluctuation band improves the quality of expectations, a channel that has been neglected in the modern literature. Second, we show that the standard test of the basic target zone model is flawed and develop an alternative methodology. We believe that these findings shed a new light on the economics of exchange rate bands

Development of an in Vitro Rat Intestine Segmental Perfusion Model to Investigate Permeability and Predict Oral Fraction Absorbed

Purpose: The aims of the study are to develop and evaluate an in vitro rat intestine segmental perfusion model for the prediction of the oral fraction absorbed of compounds and to assess the ability of the model to study intestinal metabolism. Methods: The system consisted of a perfusion cell with a rat intestinal segment and three perfusion circulations (donor, receiver, and rinsing circulation). Lucifer yellow (LY) was applied as internal standard together with test compounds in the donor circulation. To validate the model, the permeability of eight noncongeneric passively absorbed drugs was determined. Intestinal N-demethylation of verapamil into norverapamil was followed in the donor and receiver circulations by high-performance liquid chromatography analysis. Results: The in vitro model allowed ranking of the tested compounds according to their in vivo absorption potential. The Spearman's correlation coefficient between the oral fraction absorbed in humans and the ratio of permeation coefficient of test compound to the permeation coefficient of LY within the same experiment was 0.98 (P < 0.01). Moreover, intestinal N-demethylation of verapamil, its permeation, and the permeation of its metabolite norverapamil could be assessed in parallel. Conclusions: Up to six permeation kinetics can be obtained per rat, and the method has shown to be a valuable tool to estimate human oral absorptio

Relationship Between Spirituality, Meaning in Life, Psychological Distress, Wish for Hastened Death, and Their Influence on Quality of Life in Palliative Care Patients.

Spiritual, existential, and psychological issues represent central components of quality of life (QOL) in palliative care. A better understanding of the dynamic nature underlying these components is essential for the development of interventions tailored to the palliative context. The aims were to explore 1) the relationship between spirituality, meaning in life, wishes for hastened death and psychological distress in palliative patients and 2) the extent to which these nonphysical determinants influence QOL. A cross-sectional study involving face-to-face interviews with Swiss palliative patients was performed, including the Schedule for Meaning in Life Evaluation (SMILE), the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp), the Idler Index of Religiosity (IIR), the Hospital Anxiety and Depression Scale (HADS), and the Schedule of Attitudes toward Hastened Death (SAHD). QOL was measured with a single-item visual analogue scale (0-10). Two hundred and six patients completed the protocol (51.5% female; mean age = 67.5 years). The results indicated a significant negative relationship between FACIT-Sp/SMILE and HADS total scores (P = 0.000). The best model for QOL explained 32.8% of the variance (P = 0.000) and included the FACIT-Sp, SMILE, and SAHD total scores, the IIR "private religiosity" score, as well as the HADS "depression" score. Both spiritual well-being and meaning in life appear to be potential protective factors against psychological distress at the end of life. Since nonphysical determinants play a major role in shaping QOL at the end of life, there is a need for the development of meaning-oriented and spiritual care interventions tailored to the fragility of palliative patients

Врожденные мышечные дистрофии: классификация и диагностика

Congenital muscular dystrophies (CMD) are a large group of genetically determined muscular diseases, initially defined by an early onset before the age of walking and dystrophic changes on myopathologic analyses. Currently, their definition is less restrictive with, a clinical continuum with limb-girdle muscular dystrophies, and closer histomorphological aspects with congenital myopathies. We distinguish 9 different forms of DMC, classified in 6 different groups depending on the location and/or function of the protein involved, on the control of 26 different genes. Ullrich's disease, UCMD (collagenopathy involving three different genes: COL6A1, COL6A2, COL6A3); secondary dystroglycanopathies (by abnormal glycosylation of alpha-dystroglycan involving 16 different genes); and DMC merosin negative, MDC1A, (merosinopathy secondary to mutations in a unique gene, LAMA2); represent the three most common forms. Rigid spine syndrome type 1, RSMD1 (selenopathy secondary to SEPN1 gene mutation) and L-CMD (laminopathy involving LMNA gene) are also part of the most current forms. Clinical features, plasmatic creatine kinase elevation or not, the presence or absence of clinical signs of central nervous system involvement, allow a first level of diagnostic pathway. According to these elements, muscle and/or cerebral MRI, muscle and/or skin biopsy will be discussed to guide the molecular investigations that will allow accurate diagnosis.Врожденные мышечные дистрофии (ВМД) составляют клинически и генетически чрезвычайно гетерогенную группу мышечных заболеваний. Изначально ВМД рассматривались как группа болезней с дебютом в раннем детском возрасте, до начала самостоятельной ходьбы, и наличием признаков дистрофии при патогистологическом исследовании. Сегодня ВМД подразделяют не столь строго. Так, имеется целый спектр клинических форм, включающий дистрофии поясов с более поздним дебютом игистологической картиной, сближающей их с врожденными миопатиями. Различают 9 форм ВМД, распределенных на 6 групп согласно локализации и/или функции нарушенного белка и соответствующего одному из 26 генов. Чаще всего встречаются следующие формы ВМД: болезнь Ульриха (коллагенопатия, связанная с патологией 3 генов: COL6A1, COL6A2, COL6A3); вторичные дистрогликанопатии (нарушение гликозилирования α-дистрогликана с вовлечением 16 генов) и мерозин-дефицитная ВМД (мерозинопатия, обусловленная мутацией одного гена LAMA2). К классическим формам ВМД также относятся синдром ригидного позвоночника 1-го типа (селенопатия вследствие мутации гена SEPN) и L-ВМД (ламинопатия, вовлекающая ген LMNA). Диагностический поиск определяется выявлением характерной клинической картины, наличием или отсутствием признаков поражения центральной нервной системы, нормальным или умеренно повышенным уровнем креатинфосфокиназы. Выбор молекулярного исследования для уточнения диагноза определяется результатами предварительного лабораторно-инструментального обследования, включающего магнитно-резонансную томографию мышц и/или головного мозга, биопсии мышцы и/или кожи

Postpartum Hemorrhage: Differences in Definition, Data and Incidence

Introduction Postpartum hemorrhage (PPH) remains a major cause of morbidity and mortality worldwide. Geo-temporal comparisons of in-hospital PPH incidence remain a challenge due to differences in definition, data quality and the absence of accurate, validated indicators. Objectives and Approach To compare the incidence of PPH using different definitions to assess the need for a validated indicator. Singleton births from 2014-2016 at Lausanne University Hospital, Switzerland, were included. PPH was defined based on 1) clinical diagnosis using International Classification of Diseases (ICD-10-GM) PPH diagnostic codes, 2) volume of blood loss ≥500ml for vaginal births and ≥1000ml for cesareans 3) peripartum Hb change >2g/dl in vaginal births and ≥4g/dl in cesareans and 4) fulfillment of criteria from definition one, two or three. Data were extracted from hospital discharge data and linked with electronic health records. Results There were 2529, 2660 and 2715 singleton births in 2014, 2015 and 2016, respectively, 28.8% were cesareans. Peripartum change in Hb was available for 17% of births. The incidence (95% CI) of PPH in 2014, 2015 and 2016 was, respectively: 1)6.0% (5.1, 7.0), 6.3% (5.4, 7.3) and 7.9% (6.9, 9.0) based on diagnostic codes; 2)7.9% (6.8, 9.0), 7.1% (6.2, 8.2) and 7.2% (6.3, 8.3) based on blood loss volumes; 3)2.4% (1.8, 3.1), 2.7% (2.1, 3.4) and 3.5% (2.9, 4.3) based on change in Hb; 4)11.3% (10.1, 12.6), 10.4% (9.3, 11.6) and 11.0% (9.9, 12.3) based on the combined definition. Differences in PPH incidence by year between definitions one and four, two and four and three and four were all statistically significant (McNemar p-values Conclusion/Implications Incidence varied widely according to definition and data availability, not to mention data quality. Our results highlight the need for a validated PPH indicator to enable monitoring. Future prospects include the validation of a diagnostic code based PPH indicator aided by text mining in electronic health records

Absolute frequency measurement of the In+^{+} clock transition with a mode-locked laser

The absolute frequency of the In$^{+}$ $5s^{2 1}S_{0}$ - $5s5p^{3}P_{0}$ clock transition at 237 nm was measured with an accuracy of 1.8 parts in $10^{13}$. Using a phase-coherent frequency chain, we compared the $^{1}S_{0}$ - $^{3}P_{0}$ transition with a methane-stabilized He-Ne laser at 3.39 $\mu$m which was calibrated against an atomic cesium fountain clock. A frequency gap of 37 THz at the fourth harmonic of the He-Ne standard was bridged by a frequency comb generated by a mode-locked femtosecond laser. The frequency of the In$^{+}$ clock transition was found to be $1 267 402 452 899.92 (0.23)$ kHz, the accuracy being limited by the uncertainty of the He-Ne laser reference. This represents an improvement in accuracy of more than 2 orders of magnitude on previous measurements of the line and now stands as the most accurate measurement of an optical transition in a single ion.Comment: 3 pages, 2 figures. accepted for publication in Opt. Let

Upper limits on the strength of periodic gravitational waves from PSR J1939+2134

The first science run of the LIGO and GEO gravitational wave detectors presented the opportunity to test methods of searching for gravitational waves from known pulsars. Here we present new direct upper limits on the strength of waves from the pulsar PSR J1939+2134 using two independent analysis methods, one in the frequency domain using frequentist statistics and one in the time domain using Bayesian inference. Both methods show that the strain amplitude at Earth from this pulsar is less than a few times $10^{-22}$.Comment: 7 pages, 1 figure, to appear in the Proceedings of the 5th Edoardo Amaldi Conference on Gravitational Waves, Tirrenia, Pisa, Italy, 6-11 July 200