Agglomeration externalities, innovation and regional growth: Theoretical perspectives and meta-analysis

Technological change and innovation and are central to the quest for regional development. In the globally-connected knowledge-driven economy, the relevance of agglomeration forces that rely on proximity continues to increase, paradoxically despite declining real costs of information, communication and transportation. Globally, the proportion of the population living in cities continues to grow and sprawling cities remain the engines of regional economic transformation. The growth of cities results from a complex chain that starts with scale, density and geography, which then combine with industrial structure characterised by its extent of specialisation, competition and diversity, to yield innovation and productivity growth that encourages employment expansion, and further urban growth through inward migration. This paper revisits the central part of this virtuous circle, namely the Marshall-Arrow-Romer externalities (specialisation), Jacobs externalities (diversity) and Porter externalities (competition) that have provided alternative explanations for innovation and urban growth. The paper evaluates the statistical robustness of evidence for such externalities presented in 31 scientific articles, all building on the seminal work of Glaeser et al. (1992). We aim to explain variation in estimation results using study characteristics by means of ordered probit analysis. Among the results, we find that the impact of diversity depends on how it is measured and that diversity is important for the high-tech sector. High population density increases the chance of finding positive effects of specialisation on growth. More recent data find more positive results for both specialization and diversity, suggesting that agglomeration externalities become more important over time. Finally, primary study results depend on whether or not the externalities are considered jointly and on other features of the regression model specification

Basic knowledge in psychodermatology

Background The authors try to define the framework of this approach, what should be acquired by "well-informed" dermatologists and what is required to be a pyschodermatologist. Objective To better define the necessary knowledge to practice psychodermatology. Results 1) The first level is dermatology psychology: there is a psychotherapeutical implicit effect of the dermatological consultation with a goal that is not psychological change. This effect can be improved by acquiring better communication skills and information. The second level needs a possibility to change the emotional individual process and the relational context in a continuum between counselling and psychotherapy. To practice this level a complete psychotherapeutic education with some specificity is needed. This can be reached by a dermatologist also being a psychotherapist or by a team consisting of both dermatologist-psychotherapist. 2) The psychodermatological patient is characterized by alexithymia. He/she needs to be understood through the body language he/she presents. This kind of patient is coming from families where the theme of loss seems to dominate the histories and be associated with deep emotional experiences of separation anxiety. These characteristics must be known together with the different psychodermatological disorders and the mind-body interaction to handle these patients. 3) Taking all of this complexity into account, the psychodermatologist or the psychodermatological team should be able to integrate the different points and adapt attitudes to the patient's difficulty during the whole therapeutic process. 4) The evaluation of the problem should be done using psychological tools here described. Conclusion The European Academy of Dermatology and Venereology (EADV) together with the European Society for Dermatology and Psychiatry (ESDaP) are able to provide the specific education for dermatologist and psychotherapist. In the future, they could be responsible for the recognition of these special abilities and treatments on a governmental and European political level

Schatting van in situ fluxen van organische microverontreinigingen uit waterbodems

Dit rapport beschrijft de resultaten van een onderzoek naar naleveringsfluxen van organische microverontreinigingen, ten behoeve van het Deltares koploperproject “Biobeschikbaarheid en gedrag van stoffen”, deelproject A “Nalevering van stoffen uit waterbodems”. Hierin wordt het belang van nalevering voor de kwaliteit van het oppervlaktewater onderzocht. Dit project moet leiden tot inzicht in de situaties waarin nalevering van stoffen uit de waterbodem naar het oppervlaktewater een significante (secundaire) verontreinigingbron vormt. Dit met het oog op normoverschrijding in het oppervlaktewater (chemische doelstelling KRW), of het niet bereiken van een goede ecologische toestand (ecologische doelstelling KRW). In het voorliggende rapport worden de resultaten van kolom flux-experimenten besproken. Aan de orde komen: (a) opzet meetprogramma voor zover afwijkend van het meetplan, (b) informatie met betrekking tot kwaliteitscontrole, (c) specificatie van gebruikte analysevoorschriften (d) analyseresultaten met korte toelichtin

Paraneoplastic pemphigus

Paraneoplastic pemphigus is a rare but severe potentially fatal autoimmune disease characterized by severe stomatitis and a variety of cutaneous manifestations in association with an underlying neoplasia. Pulmonary involvement may also occur. The pathogenesis involves the production of autoantibodies against desmogleins, plakins and the protease inhibitor alpha-2 macroglobuline like-1, but T-cell mediated autoimmunity is also thought to play a role. Diagnosis usually relies on the demonstration of a specific subset of circulating autoantibodies in patient serum, although in a small subset of patients these autoantibodies might be absent. Due to it's rarity, there are no guidelines for the treatment of PNP. The general approach includes a variety of immunosuppressive agents and treatment of the underlying neoplasia. Despite treatment, paraneoplastic pemphigus has high mortality rates, often due to sepsis, respiratory failure or progression of the underlying malignancy.</p

Paraneoplastic pemphigus with fatal bronchiolitis obliterans

Paraneoplastic pemphigus (PNP) is a rare autoimmune bullous disease, associated with high mortality and morbidity. Accurate serological tools exist to confirm its diagnosis, providing the clinician considers this diagnosis. We present a case of a young woman with a painful stomatitis, which had been treated, prior to presentation at our clinic as erosive lichen planus. Additional serological tests led to the diagnosis paraneoplastisch pemphigus (PNP), which lead to further oncological screening. An intra-abdominal follicular dendritic cell sarcoma was found. Despite surgical removal of the sarcoma and treatment with high dose systemic corticosteroids, rituximab, and intraveneous immunoglobulins, the stomatitis persisted and the patient developed a bronchiolitis obliterans from which she died, six months after the diagnosis . This case illustrates the fulminant path that PNP can follow , and calls for further studies aimed at identifying the risk factors and optimal therapeutic regimens for bronchiolitis obliterans and PNP.</p

The Framingham Risk Score Is Associated with Chronic Graft Failure in Renal Transplant Recipients

Predicting chronic graft failure in renal transplant recipients (RTR) is an unmet clinical need. Chronic graft failure is often accompanied by transplant vasculopathy, the formation of de novo atherosclerosis in the transplanted kidney. Therefore, we determined whether the 10-year Framingham risk score (FRS), an established atherosclerotic cardiovascular disease prediction module, is associated with chronic graft failure in RTR. In this prospective longitudinal study, 600 well-characterised RTR were followed for 10 years. The association with death-censored chronic graft failure (n = 81, 13.5%) was computed. An extended Cox model showed that each one percent increase of the FRS significantly increased the risk of chronic graft failure by 4% (HR: 1.04, p &lt; 0.001). This association remained significant after adjustment for potential confounders, including eGFR (HR: 1.03, p = 0.014). Adding the FRS to eGFR resulted in a higher AUC in a receiver operating curve (AUC = 0.79, p &lt; 0.001) than eGFR alone (AUC = 0.75, p &lt; 0.001), and an improvement in the model likelihood ratio statistic (67.60 to 88.39, p &lt; 0.001). These results suggest that a combination of the FRS and eGFR improves risk prediction. The easy to determine and widely available FRS has clinical potential to predict chronic graft failure in RTR.</p

Accuracy and repeatability of joint sparsity multi-component estimation in MR Fingerprinting

MR fingerprinting (MRF) is a promising method for quantitative characterization of tissues. Often, voxel-wise measurements are made, assuming a single tissue-type per voxel. Alternatively, the Sparsity Promoting Iterative Joint Non-negative least squares Multi-Component MRF method (SPIJN-MRF) facilitates tissue parameter estima-tion for identified components as well as partial volume segmentations. The aim of this paper was to evaluate the accuracy and repeatability of the SPIJN-MRF parameter estimations and partial volume segmentations. This was done (1) through numerical simulations based on the BrainWeb phantoms and (2) using in vivo acquired MRF data from 5 subjects that were scanned on the same week-day for 8 consecutive weeks. The partial volume segmen-tations of the SPIJN-MRF method were compared to those obtained by two conventional methods: SPM12 and FSL. SPIJN-MRF showed higher accuracy in simulations in comparison to FSL-and SPM12-based segmentations: Fuzzy Tanimoto Coefficients (FTC) comparing these segmentations and Brainweb references were higher than 0.95 for SPIJN-MRF in all the tissues and between 0.6 and 0.7 for SPM12 and FSL in white and gray matter and between 0.5 and 0.6 in CSF. For the in vivo MRF data, the estimated relaxation times were in line with literature and minimal variation was observed. Furthermore, the coefficient of variation (CoV) for estimated tissue volumes with SPIJN-MRF were 10.5% for the myelin water, 6.0% for the white matter, 5.6% for the gray matter, 4.6% for the CSF and 1.1% for the total brain volume. CoVs for CSF and total brain volume measured on the scanned data for SPIJN-MRF were in line with those obtained with SPM12 and FSL. The CoVs for white and gray mat-ter volumes were distinctively higher for SPIJN-MRF than those measured with SPM12 and FSL. In conclusion, the use of SPIJN-MRF provides accurate and precise tissue relaxation parameter estimations taking into account intrinsic partial volume effects. It facilitates obtaining tissue fraction maps of prevalent tissues including myelin water which can be relevant for evaluating diseases affecting the white matter.Radiolog