Using dynamic microsimulation to understand professional trajectories of the active Swiss population

Within the social and economic sciences and of particular interest to demographers are life course events. Looking at life sequences we can better understand which states, or life events, precede or are precursors to vulnerability. A tool that has been used for policy evaluation and recently has been gaining ground in life course sequence simulation is dynamic microsimulation. Within this context dynamic microsimulation consists in generating entire life courses from the observation of portions of the trajectories of individuals of different ages. In this work, we aim to use dynamic microsimulation in order to analyse individual professional trajectories with a focus on vulnerability. The primary goal of this analysis is to deepen upon current literature by providing insight from a longitudinal perspective on the signs of work instability and the process of precarity. The secondary goal of this work which is to show how, by using microsimulation, data collected for one purpose can be analysed under a different scope and used in a meaningful way. The data to be used in this analysis are longitudinal and were collected by NCCR-LIVES IP207 under the supervision of Prof. Christian Maggiori and Dr. Gregoire Bollmann. Individuals aged 25 to 55 residing in the German-speaking and French-speaking regions of Switzerland were followed annually for four years. These individuals were questioned regarding, amongst their personal, professional and overall situations and well-being. At the end of the fourth wave, there were 1131 individuals who had participated in all waves. The sample remained representative of the Swiss population with women and the unemployed slightly over represented. Using the information collected from these surveys, we use simulation to construct various longitudinal data modules where each data module represents a specific life domain. We postulate the relationship between these modules and layout a framework of estimation. Within certain data modules a set of equations are created to model the process therein. For every dynamic (time-variant) data module, such as the labour-market module, the transition probabilities between states (ex. labour market status) are estimated using a Markov model and then the possible outcomes are simulated. The benefit of using dynamic microsimulation is that longitudinal sample observations instead of stylised profiles are used to model population dynamics. This is one of the main reasons large-scale dynamic microsimulation models are employed by many developed nations. There has been limited use, however, of such approaches with Swiss data. This work contributes to the analysis of professional trajectories of the active Swiss population by utilising dynamic microsimulation methods

Increased expression of blood muscarinic receptors in patients with reflex syncope

International audienceAIMS:Pathophysiology of reflex syncope is not fully understood but a vagal overactivity might be involved in this syncope. Previously, overexpression of muscarinic M2 receptors and acetylcholinesterase was found in particular in the heart and in lymphocytes of rabbits with vagal overactivity as well as in hearts of Sudden Infant Death Syndromes. The aim of this present study was to look at M2 receptor expression in blood of patients with reflex syncope. The second objective was to measure acetylcholinesterase expression in these patients.METHODS AND RESULTS:136 subjects were enrolled. This monocenter study pooled 45 adults exhibiting recurrent reflex syncope compared with 32 healthy adult volunteers (18-50 years) and 38 children exhibiting reflex syncope requiring hospitalization compared with 21 controls (1-17 years). One blood sample was taken from each subject and blood mRNA expression of M2 receptors was assessed by qRT-PCR. Taking into account the non-symmetric distributions of values in both groups, statistical interferences were assessed using bayesian techniques. A M2 receptor overexpression was observed in adult and pediatric patients compared to controls. The medians [q1;q3] were 0.9 [0.3;1.9] in patients versus 0.2 [0.1;1.0] in controls; the probability that M2 receptor expression was higher in patients than in controls (Pr[patients>controls]) was estimated at 0.99. Acetylcholinesterase expression was also increased 0.7 [0.4;1.6] in patients versus 0.4 [0.2;1.1] in controls; the probability that acetylcholinesterase expression was higher in patients than in controls (Pr[patients>controls]) was estimated at 0.97. Both in adults and children, the expression ratio of M2 receptors over acetylcholinesterase was greater in the patient group compared with the control group.CONCLUSION:M2 receptor overexpression has been detected in the blood of both, adults and children, exhibiting reflex syncope. As in our experimental model, i.e. rabbits with vagal overactivity, acetylcholinesterase overexpression was associated with M2 receptor overexpression. For the first time, biological abnormalities are identified in vagal syncope in which only clinical signs are, so far, taken into account for differential diagnosis and therapeutic management. Further work will be needed to validate potential biomarkers of risk or severity associated with the cholinergic system