Water-filtered infrared-A radiation (wIRA) is not implicated in cellular degeneration of human skin

Rapport de synthèse : Introduction : le vieillissement cutané est un processus biologique complexe auquel participe une exposition excessive au rayonnement ultraviolet du soleil. En particulier, les longueurs d'onde des rayons ultraviolets A et B (UV-A et UV-B) peuvent induire une augmentation de la synthèse de protéases, comme la métalloprotéinase matricielle 1 (MMP-1), qui est impliquée dans le processus de vieillissement. La thermothérapie par infrarouges, dont les longueurs d'onde sont plus longues que celles des UV, est largement utilisée à des fins thérapeutiques ou cosmétiques. Or, il a été démontré que les infrarouges en filtration aqueuse (IRFA) pouvaient induire une augmentation de la production de MMP-1 et par conséquent être nocifs. Il serait donc intéressant d'évaluer les effets des IRFA au niveau cellulaire et moléculaire. But Expérimental : étudier les effets des lampes à infrarouges en filtration aqueuse utilisées en clinique sur des fibroblastes cutanés humains en culture, afin d'analyser l'expression du gène codant pour la protéine MMP-1. Méthode : des fibroblastes cutanés humain ont été irradiés d'une part avec approximativement 88% d'IRFA (780-1400 nm) et 12% de lumière rouge (LR, 665-780 nm) avec 380 mW/cm2 IRFA(+LR) (333 mW/cm2 IRFA) et d'autre part avec des UV-A comme contrôle. Des courbes de survie cellulaire ont été établies après une exposition allant de 15 minutes à 8 heures au IRFA(+LR) (340-10880 J/cm2 wIRA(+RL), 300-9600 J/cm2 wIRA) ou de 15 à 45 minutes aux UV-A(+BL) (25-75 J/cm2 UV-A(+BL). L'induction de l'ARNm du gène de la MMP-1 a été analysé dans les fibroblastes cutanés humain à deux températures physiologiques (30°C et 37°C) lors d'expositions uniques de 15 à 60 minutes aux IRFA(+LR) (340-1360 J/cm2 IRFA(+LR), 300-1200 J/cm2 IRFA) ou de 30 minutes aux UV-A(+BL) (50 J/cm2 UVA(+BL)). De plus, nous avons effectué des irradiations répétées, une a chaque passage cellulaire jusqu'au passage. 10 de 15 minutes d'IRFA(+LR) 340 J/cm2 IRFA(+LR), 300 J/cm2 IRFA) . Résultats : une exposition unique aux UV-A (+BL) entraîne chez des fibroblastes cutanés humains une augmentation de la mort cellulaire, ainsi qu'une forte augmentation de l'expression du gène codant pour la MMP-1. L'augmentation mise en évidence pour cet ARNm varie en fonction de la technique utilisée : elle est de 11 ± 1 fois par RT-PCR classique, de 76 ± 2 fois par RT-PCR quantitative à 30°C, et de 75 ± 1 fois par RT-PCR quantitative à 37°C. Par contre, une exposition unique ou répétée aux IRFA (+LR) n'induit aucune augmentation de la mort cellulaire, ni de l'expression de l'ARNm de la MMP-1 chez ces fibroblastes. Conclusions : les résultats de cette étude montrent que, contrairement aux rayons ultraviolets, les IRFA (+LR) ne semblent impliqués ni dans le vieillissement, ni dans la mort cellulaire, même utilisés à des doses très élevées. Ces résultats sont en accord avec certaines investigations in vivo montrant une induction de MMP-1 par des UV et non des infrarouges. Ces dernières études suggèrent d'ailleurs plutôt un rôle protecteur des IRFA (+LR).

Alpha1-adrenoceptor-dependent vascular hypertrophy and remodeling in murine hypoxic pulmonary hypertension.

Excessive proliferation of vascular wall cells underlies the development of elevated vascular resistance in hypoxic pulmonary hypertension (PH), but the responsible mechanisms remain unclear. Growth-promoting effects of catecholamines may contribute. Hypoxemia causes sympathoexcitation, and prolonged stimulation of alpha(1)-adrenoceptors (alpha(1)-ARs) induces hypertrophy and hyperplasia of arterial smooth muscle cells and adventitial fibroblasts. Catecholamine trophic actions in arteries are enhanced when other conditions favoring growth or remodeling are present, e.g., injury or altered shear stress, in isolated pulmonary arteries from rats with hypoxic PH. The present study examined the hypothesis that catecholamines contribute to pulmonary vascular remodeling in vivo in hypoxic PH. Mice genetically deficient in norepinephrine and epinephrine production [dopamine beta-hydroxylase(-/-) (DBH(-/-))] or alpha(1)-ARs were examined for alterations in PH, cardiac hypertrophy, and vascular remodeling after 21 days exposure to normobaric 0.1 inspired oxygen fraction (Fi(O(2))). A decrease in the lumen area and an increase in the wall thickness of arteries were strongly inhibited in knockout mice (order of extent of inhibition: DBH(-/-) = alpha(1D)-AR(-/-) > alpha(1B)-AR(-/-)). Distal muscularization of small arterioles was also reduced (DBH(-/-) > alpha(1D)-AR(-/-) > alpha(1B)-AR(-/-) mice). Despite these reductions, increases in right ventricular pressure and hypertrophy were not attenuated in DBH(-/-) and alpha(1B)-AR(-/-) mice. However, hematocrit increased more in these mice, possibly as a consequence of impaired cardiovascular activation that occurs during reduction of Fi(O(2)). In contrast, in alpha(1D)-AR(-/-) mice, where hematocrit increased the same as in wild-type mice, right ventricular pressure was reduced. These data suggest that catecholamine stimulation of alpha(1B)- and alpha(1D)-ARs contributes significantly to vascular remodeling in hypoxic PH.

Cannabis use in a Swiss male prison: qualitative study exploring detainees' and staffs' perspectives.

BACKGROUND: Several studies suggest a high prevalence of cannabis use before and during imprisonment, but subjective perspectives of detainees and staff towards its use in prison are lacking. This issue was explored in the framework of an observational study addressing tobacco use in three Swiss prisons in 2009 and 2010 that involved multiple strands (quantitative and qualitative components). This article presents qualitative data on cannabis use collected in one of the settings. METHODS: We used in-depth semi-structured interviews with both detainees and staff to explore their attitudes towards cannabis in one post-trial male Swiss prison. We performed specific coding and thematic analysis for cannabis with the support of ATLAS.ti, compared detainees' and staff's opinions, and considered the results with regard to drug policy in prison in general. RESULTS: 58 participants (31 male offenders, mean age 35 years, and 27 prison staff, mean age 46 years, 33% female) were interviewed. Detainees estimated the current use of cannabis use to be as high as 80%, and staff 50%. Participants showed similar opinions on effects of cannabis use that were described both at individual and institutional levels: analgesic, calming, self-help to go through the prison experience, relieve stress, facilitate sleep, prevent violence, and social pacifier. They also mentioned negative consequences of cannabis use (sleepiness, decreased perception of danger and social isolation), and dissatisfaction regarding the ongoing ambiguous situation where cannabis is forbidden but detection in the urine was not sanctioned. However, the introduction of a more restrictive regulation induced fear of violence, increased trafficking and a shift to other drug use. CONCLUSION: Although illegal, cannabis use is clearly involved in daily life in prison. A clearer and comprehensive policy addressing cannabis is needed, including appropriate measures tailored to individual users. To sustain a calm and safe environment in prison, means other than substance or medication use are required.

Assessment of free-living physical activity in humans: an overview of currently available and proposed new measures.

The number of physical activity measures and indexes used in the human literature is large and may result in some difficulty for the average investigator to choose the most appropriate measure. Accordingly, this review is intended to provide information on the utility and limitations of the various measures. Its primary focus is the objective assessment of free-living physical activity in humans based on physiological and biomechanical methods. The physical activity measures have been classified into three categories: Measures based on energy expenditure or oxygen uptake, such as activity energy expenditure, activity-related time equivalent, physical activity level, physical activity ratio, metabolic equivalent, and a new index of potential interest, daytime physical activity level. Measures based on heart rate monitoring, such as net heart rate, physical activity ratio heart rate, physical activity level heart rate, activity-related time equivalent, and daytime physical activity level heart rate. Measures based on whole-body accelerometry (counts/U time). Quantification of the velocity and duration of displacement in outdoor conditions by satellites using the Differential Global Positioning System may constitute a surrogate for physical activity, because walking is the primary activity of man in free-living conditions. A general outline of the measures and indexes described above is presented in tabular form, along with their respective definition, usual applications, advantages, and shortcomings. A practical example is given with typical values in obese and non-obese subjects. The various factors to be considered in the selection of physical activity methods include experimental goals, sample size, budget, cultural and social/environmental factors, physical burden for the subject, and statistical factors, such as accuracy and precision. It is concluded that no single current technique is able to quantify all aspects of physical activity under free-living conditions, requiring the use of complementary methods. In the future, physical activity sensors, which are of low-cost, small-sized, and convenient for subjects, investigators, and clinicians, are needed to reliably monitor, during extended periods in free-living situations, small changes in movements and grade as well as duration and intensity of typical physical activities.

Physical activity and pregnancy

SUMMARY : The traditional medical advice for pregnant women has been to reduce their physical activity (PA) levels. The advice was based on concerns that exercise could affect pregnancy outcomes by increasing core body temperature, by increasing the risk of maternal musculoskeletal injury and by altering the transplacental transport of oxygen and nutrients to maternal skeletal muscle rather than to the developing foetus. In the meantime, several studies have provided new information on adaptation of the pregnant woman and her foetus to moderate PA. New investigations have shown no adverse maternal or neonatal outcomes, abnormal foetal growth, increase in early pregnancy loss, or late pregnancy complications. Moreover, enrolment in moderate PA has proven to result in marked health benefits including improved maternal cardiovascular function, reduction of excessive weight gain and fat retention, less complicated labour, improved foetal stress tolerance and neurobehavioral maturation. In view of the beneficial effects, current recommendations encourage healthy pregnant women to engage in 30 minutes of moderate PA on most, if not all, days of the week. This thesis work addressed several questions. Firstly, it examined whether compliance with the recommended levels of PA during pregnancy results in better preparedness for the sudden physical exertion of labour and delivery. Secondly, it measured PA during pregnancy as compared to postpartum. Lastly, it assessed the influence of pre-pregnancy body mass index on gestational resting metabolic rate. Data collection was conducted on healthy women living in Switzerland during the third trimester of pregnancy and postpartum. Total and activity energy expenditure was assessed through 24-hour heart rate and accelerations recordings, and cardiovascular fitness through an individual step-test. Information related to pregnancy, labour and delivery was collected from medical records. The results indicate that a minimum 30 min of moderate PA per day during pregnancy are associated with better cardiovascular fitness and lower risk of operative delivery with no negative effects on maternal and foetal conditions (study 1). Despite these benefits, a substantial proportion of pregnant women (39%) living in Switzerland do not meet the PA recommendations. The decrease in activity related energy expenditure during pregnancy compared to postpartum was measured to be around 100 kcal/day (~13%), whereas the total energy expenditure was found to increase by 300 kcal/day (study 2). Thus, the energy cost of late pregnancy in Switzerland corresponds to 200 kca/day. These findings are based on average values of the study group. It should be noted, however, that large variations in individual energy expenditure may occur depending on the pre-pregnancy body mass index (study 3). When adjusted to body weight, gestational resting metabolic rate is significantly lower among women of high pre-pregnancy body mass index compared to women of normal or low pre-pregnancy body mass index. This can be explained by the fact that resting metabolic rate is primarily a function of fat-free mass, and when expressed per kg body weight, it decreases as the percentage of body fat increases. If energy intake is not modified appropriately in order to match lower energy cost per kg body weight in overweight and obese women it will result in positive energy balance, thus contributing to the current trend towards increasing adiposity in affluent society. The results of these studies go beyond the current state of knowledge on PA and pregnancy (study 4) and provide valid evidence to guide clinical practice. In view of the current epidemic of sedentary behaviour and obesity related pathology, the findings contribute new and reliable information to public health policies regarding the effects of PA in pregnancy, an important period of life for both mother and infant.

Bien commun, conflits d'intérêts et délibération éthique

Si La notion de Bien commun paraît de prime abord trop ambitieuse, trompeuse en ses promesses excessives et inaccessibles, elle est néanmoins nécessaire au débat éthique dans l'espace public contemporain. Dans cette contribution, nous voudrions montrer comment une compréhension critique de la notion controversée de Bien commun peut s'avérer compatible avec une prise en compte réaliste et responsable des conflits d'intérêts et de la délibération éthique. L'exemple du débat français sur la laïcité permet à cet égard de comprendre la nécessité de dépasser l'opposition stérile entre un communautarisme poussé à l'extrême et un universalisme vidé de sa pertinence historique et dialectique. If, at the first look, the notion of the common Good seems too ambitious, making excessive and unaccessible promises, it is nevertheless necessary to use it in the ethical public discussion. This paper aims to show that a critical understanding of this controversial idea of the common Good may help to solve some conflicts of interests. The example of the french debate on laicity should help us to overcome the fallacious opposition between extreme communitarianism and abstract universalism.

Effective exposure to solar UV in building workers: influence of local and individual factors.

Excessive exposure to solar UV light is the main cause of skin cancers in humans. UV exposure depends on environmental as well as individual factors related to activity. Although outdoor occupational activities contribute significantly to the individual dose received, data on effective exposure are scarce and limited to a few occupations. A study was undertaken in order to assess effective short-term exposure among building workers and characterize the influence of individual and local factors on exposure. The effective exposure of construction workers in a mountainous area in the southern part of Switzerland was investigated through short-term dosimetry (97 dosimeters). Three altitudes, of about 500, 1500 and 2500 m were considered. Individual measurements over 20 working periods were performed using Spore film dosimeters on five body locations. The postural activity of workers was concomitantly recorded and static UV measurements were also performed. Effective exposure among building workers was high and exceeded occupational recommendations, for all individuals for at least one body location. The mean daily UV dose in plain was 11.9 SED (0.0-31.3 SED), in middle mountain 21.4 SED (6.6-46.8 SED) and in high mountain 28.6 SED (0.0-91.1 SED). Measured doses between workers and anatomical locations exhibited a high variability, stressing the role of local exposure conditions and individual factors. Short-term effective exposure ranged between 0 and 200% of ambient irradiation, indicating the occurrence of intense, subacute exposures. A predictive irradiation model was developed to investigate the role of individual factors. Posture and orientation were found to account for at least 38% of the total variance of relative individual exposure, and were also found to account more than altitude on the total variance of effective daily exposures. Targeted sensitization actions through professional information channels and specific prevention messages are recommended. Altitude outdoor workers should also benefit from preventive medical examination.

Papilledema and obstructive sleep apnea syndrome.

OBJECTIVES: To characterize the pathogenesis and clinical features of optic disc edema associated with obstructive sleep apnea syndrome (SAS). METHODS: A series of 4 patients with SAS and papilledema (PE) underwent complete neuro-ophthalmologic evaluation and lumbar puncture. In 1 patient, continuous 24-hour intracranial pressure (ICP) monitoring was also performed. RESULTS: All 4 patients had bilateral PE that was asymmetric in 2. Three patients had optic nerve dysfunction, asymmetric in 1, unilateral in 2. Daytime cerebrospinal fluid pressure measurements were within normal range. Nocturnal monitoring performed in one patient, however, demonstrated repeated episodes of marked ICP elevation associated with apnea and arterial oxygen desaturation. CONCLUSIONS: We propose that PE in SAS is due to episodic nocturnal hypoxemia and hypercarbia resulting in increased ICP secondary to cerebral vasodilation. In these individuals, intermittent ICP elevation is sufficient to cause persistent disc edema. These patients may be at increased risk for developing visual loss secondary to PE compared with patients with obesity-related pseudotumor cerebri because of associated hypoxemia. The diagnosis of SAS PE may not be appreciated because daytime cerebrospinal fluid pressure measurements are normal and because patients tend to present with visual loss rather than with symptoms of increased ICP.

Eretria - Nea Psara : eine klassizistische Stadtanlage über der antiken Polis

Résumé: Le présent ouvrage propose une histoire de l'Erétrie moderne, de la redécouverte du site antique au projet urbanistique de 1834 pour une ville nouvelle destinée à accueillir les réfugiés de l'île de Psara - anéantie en 1824 par les Ottomans - et au développement urbain d'Erétrie/Nea Psara au XIXe et au XXe siècles. Le nom d'Erétrie englobe trois couches historiques distinctes: la cité antique, la ville néoclassique, dessinée par l'architecte allemand Eduard Schaubert (1804-1860), et le village moderne, issu de son projet. Chacune de ces strates - vestiges antiques, tissu urbain néoclassique et constructions plus récentes - est perceptible au sein de cet ensemble urbain et se trouve en relation constante avec les autres. L'exposé des recherches archéologiques - depuis la redécouverte du site antique par Ciriaco de' Pizzicolli d'Ancona (Cyriaque d'Ancône) en 1436 déjà, puis de manière systématique par des voyageurs-archéologues dès le XIXe siècle - comble une lacune dans l'historiographie de la cité antique. Cette approche met également en lumière la relation étroite entre archéologie et urbanisme au XIXe siècle. Si l'exploration de la Grèce avait été jusqu'à son indépendance en 1827 essentiellement le fait des archéologues, des historiens et des philologues, après cette date, des géologues, des ingénieurs et des topographes travaillant pour le développement économique du jeune Etat se mirent également à parcourir le pays, le regard tourné non plus seulement vers l'Antiquité, mais aussi vers l'avenir. L'histoire de la redécouverte d'Erétrie permet ainsi d'éclairer divers aspects liés à la gestation de l'Etat grec. Le projet conçu en 1834 par Ecluard Schaubert de ville néoclassique superposée aux ruines de la cité antique d'Erétrie s'inscrit dans un réseau de créations de villes nouvelles et de modernisations de villes existantes par le nouvel Etat grec, qui cherchait à fonder sa légitimité et son identité, après la domination ottomane, sur les valeurs idéales (ou idéalisées) de l'Antiquité classique. Dans le projet de développement urbain d'Erétrie, la relation étroite entre archéologie et urbanisme et, par conséquent, la référence à l'Antiquité sont évidentes: Eduard Schaubert commença par tracer sur son plan toutes les ruines antiques, dressant ainsi l'état des connaissances archéologiques du site. Sur cette base, l'architecte conçut la ville néoclassique en y incluant les principales ruines, qui devaient servir de repères visuels et qui concrétisaient ainsi le lien idéologique de la monarchie absolue avec l'Antiquité. A Erétrie, deux perspectives principales reliaient le port à l'acropole et l'Ecole navale au théâtre antique. L'intégration de ruines antiques dans un projet urbanistique avait été réalisée par Stamatios Kleanthes et Eduard Schaubert en 1831-1832 dans le plan de l'Athènes moderne, avant que celle-ci n'ait été promue capitale de la Grèce. Les deux architectes ont ainsi anticipé le caractère idéal d'Athènes dans le processus de gestation de l'Etat grec. L'importance de ce plan et de celui qu'ifs ont établi sur le même modèle pour le Pirée a été reconnue par les historiens de l'urbanisme. En revanche, le plan d'Erétrie, qui suit pourtant les mêmes principes, n'a été que partiellement étudié. Cette monographie montre que le projet d'Erétrie était le plus abouti des trois, qui tous se caractérisent par un système de routes rayonnant depuis le siège du gouvernement (résidences royales à Athènes et au Pirée, mairie à Erétrie). Cet éventail de rues ou u patte d'oie» embrasse à Athènes l'acropole et au Pirée fa baie du port, alors qu'a Erétrie il est double, axé en raison de la topographie sur l'acropole et sur Pa baie du port. Cette double patte d'oie crée ainsi le lien idéologique avec l'Antiquité et témoigne, par son ouverture sur le port, de l'essor économique souhaité par le gouvernement. Le plan d'Erétrie représente de manière exemplaire l'urbanisme programmatique de la Grèce sous Othon ler (1832-1862). L'ouvrage s'intéresse ensuite à la réalisation du projet de Schaubert, dont la mise en oeuvre n'a pas répondu aux attentes du Gouvernement. Le faible développement d'Erétrie s'explique principalement par le surdimensionnement du projet, des finances publiques modestes, la malaria endémique et une politique économique inadaptée aux traditions commerciales des Psariotes. Les lenteurs dans la réalisation du projet et même des régressions au cours du XIXe siècle et au début du XXe siècle, puis l'urbanisation accélérée d'Erétrie à partir des années 1960, ont eu pour conséquence que les historiens de l'urbanisme et les urbanistes ont sous-estimé, voire ignoré la valeur historique de ce concept Cependant, l'exécution du projet néoclassique s'est poursuivie de manière continue et des références au plan de Schaubert peuvent être observées dans l'aménagement récent de la localité aujourd'hui encore. Ainsi, des arbres ont été plantés dans les années 1960 le long de l'enceinte urbaine antique, à l'emplacement où Schaubert avait prévu la création d'une promenade arborée. Au centre d'Erétrie, là où l'agora principale aurait dû être aménagée, une grande place publique servant au marché hebdomadaire a été créée. Dans le quartier oriental, une petite église dédiée à la Pan hagia Paravouniotissa a été construite en 2001 sur la parcelle où Schaubert en avait prévue une. D'importants éléments des projets de Schaubert, qui ne sont actuellement plus guère perceptibles à Athènes et au Pirée, le sont toujours à Erétrie. Les espaces verts, par exemple, occupent une place importante dans le domaine privé: malgré la densification du tissu urbain, des parcelles caractéristiques contiennent encore des maisons isolées d'un ou de deux niveaux côté rue, avec un grand jardin à l'arrière, séparé des parcelles voisines par un mur en pierre ou en brique crue. Erétrie mérite donc une reconnaissance plus considérable dans l'histoire de l'urbanisme, puisqu'elle contribue à faire mieux comprendre les projets de ses deux villes soeurs. L'étude du projet urbanistique est complétée par une approche typologique des constructions néoclassiques d'Erétrie qui souligne encore la valeur historique de cet ensemble. Comme la plupart des édifices sont, menacés de démolition, à l'exception d'un petit nombre d'entre eux qui bénéficient d'un bon entretien, un inventaire photographique des constructions d'Erétrie datant du XIXe et du début du XXe siècle a été constitué entre 1994 et 2005, complété par des photographies anciennes. Il en ressort que les formes et les techniques de construction sont représentatives de l'architecture privée à l'époque de la création de l'Etat. Enfin, le plan directeur d'Erétrie, réalisé en 1975-1976 par un séminaire du Département d'architecture de l'Ecole polytechnique fédérale de Zurich avec l'appui de l'Ecole suisse d'archéologie en Grèce, est publié ici intégralement pour la première fois. Le présent ouvrage rend ses lettres de noblesse à un ensemble urbain néoclassique, certes modeste, mais issu d'un projet urbanistique ambitieux, témoin significatif du programme politique du nouvel Etat grec. SUMMARY Translated by William Eisler This book gives an account of the history of modern Eretria. It encompasses the rediscovery of the ancient city, the 1834 urban plan for the new town designed to accommodate the refugees from the island of Psara - destroyed by the Ottomans in 1824 - and also the urban development of Eretria/Nea Psara in the 19th and 20th centuries. The name Eretria carries a rich heritage: the ancient city, the neoclassical town designed by the Germen architect Eduard Schaubert (1804-1860), and the modern village. These three distinct historical layers ancient ruins, neoclassical plan and more recent constructions - can be seen within this urban area and are interlinked with each other. The account of the archeological investigations fills a gap in the historiography of the ancient city. This started with the early rediscovery of the ancient site by Ciriaco de'Pizzicolli d'Ancona in 1436, and was followed by systematic research by travellers/ archeologists from the 19th century onward. Furthermore, this shows the close relationship between archeology and urbanism in the 19th century. The exploration of Greece prier te its independence in 1827 was mainly red by archeologists, historians and philologists. Subsequently, geologists, engineers and topographers working for the young state's economic development travelled across the country, with their attention focused not only on Antiquity but are on the future. The history of Eretria's rediscovery gives new insights on various aspects related to the development of the Greek state. In 1834, Eduard Schaubert's project, planning a neoclassical town built upon the ancient Eretria, took place alongside the development of other new cities and the modernization of existing ones du ring the Ottoman domination. By doing so, the new Greek state wanted to build its legitimacy and identity, based upon the ideal (or idealized) values of Classical Antiquity. In the urban development of Eretria, the close connection between archeology and urbanism, and the reference to Antiquity, are obvious. Eduard Schaubert began by tracing on his plan ail of the ancient ruins, thus showing the knowledge of the archeological site at that time. On this basis, the architect planned the neoclassical town, incorporating the principal ruins which were to serve as visual references embodying the ideological link between Antiquity and King Otto's absolute monarchy. In Eretria, two principal visual axes linked the port to the acropolis and the Naval School to the ancient theatre. The integration of ancient ruins in an urban project had already been achieved by Stamatios Kleanthes and Eduard Schaubert in 1831-1832 in their plan for modern Athens, before it became the capital of Greece. The two architects had therefore anticipated the ideal character of Athens at the beginning of the Greek state. The importance of this plan and that of Piraeus (designed along the same model) has long been recognized by urban historians. By contrast, the plan of Eretria based open the same principles has been only partly studied. This book explains clearly that the Eretria project was the most elaborate. The three cities are characterized by a system of roads radiating from the seat of government (the royal residences in Athens and Piraeus, the town hall in Eretria). This fan-like arrangement of streets includes the Acropolis in Athens and the harbour in Piraeus, whereas in Eretria it is twofold, orientated towards the acropolis and the harbour on account of the topography. This double fan-like arrangement shows the ideological link with Antiquity and, with its opening onto the harbour, the government's desire for economic development. The plan of Eretria is a typical ex- ample of the programmatic urbanism of Greece under Otto I (1832-1862). The book discusses the completion of Schaubert's project, which was not fully carried out as expected by the government. The poor development of Eretria can be explained primarily by the excessive scale of the project, the modest public finances, the endemic malaria and an economic policy unsuitable to the commercial traditions of the Psariotes. Delays, even regressions in the implementation of the project in the course of the 19th and the beginning of the 20th centuries, followed by the growing urbanization of Eretria starting in the 1960's, led urban historians and town planners to underestimate or even to ignore the historical value of this concept. Nevertheless, the neoclassical project was carried out steadfastly, and references to the Schaubert plan can still be seen in the modern layout of the town. Trees were planted in the 1960's all along the circumference of the ancient city, where Schaubert had planned a tree-lined promenade. A big public square serving as a weekly market place was created in the centre of Eretria, where the principal agora had been originally planned. In 2001 a small church dedicated to the Panhagia Paravouniotissa was built on a plot of land in the eastern district, where this had been intended by Schaubert. Important elements of Schaubert's projects, which are barely perceptible in modern-day Athens and Piraeus, remain visible in Eretria. Green areas, for example, occupy a significant place within the private properties. In spite of the urban densification, characteristic plots still include isolated houses of one or two stories facing the street, with large gardens in the rear, separated from neighbours by stone or mudbrick walls. Eretria therefore deserves a more prominent position in the history of urbanism, as it contributes to a better understanding of ifs two sister cities. The study of the urban project is enriched by a typological approach to the neoclassical constructions of Eretria, underlining once again the historical value of this heritage. Since only a small number of the buildings have benefited from good maintenance and the greater part is threatened with demolition, a photographic inventory of the constructions of Eretria dating from the 19tIt and early 20th centuries was produced between 1994 and 2005, supplemented by old photographs. This documentation clearly shows that the forms and techniques of construction are characteristic of private architecture at the beginning of modern Greece. Finally, the master plan of Eretria drafted in 1975-1976 by a seminar of the Department of Architecture of the Swiss Federal Institute of Technology, Zurich, with the support of the Swiss School of Archeology in Greece, is published here in full for the first time. This book gives credit to a neoclassical urban heritage which, although modest in scale, derives from an ambitious project that embodies the political programme of the new Greek state. ΠΕΡΙΛΗΨΗ Μετάβραση Ελενή Δημητρακοπούλου Η παρούσα εργασία προτείνει μια. ιστορία της σύγχρονης πόλης της Ερέτριας, ξεκινώντας από την αποκάλύψη του αρχαιολογικού χώρου, περνώντας από την σύνταξη, το 1834, του ρυμοτομικού σχεδίου για μια νέα. πόλη που σκοπό είχε να υποδεχθεί τούς πρόσφυγες από τα Ψαρά. - που καταστράφηκαν ολοσχερώς το 1824 από τούς Οθωμανούς - και εξετάζοντας τέλος την πολεοδομική εξέλιξη της Ερέτριας/Νέων Ψαρών κατά τον 19° και τον 20° αι. Πίσω από το όνομα της Ερέτριας κρύβονται τρία διαφορετικά. ιστορικά στρώματα,: η αρχαία πόλη, η νεοκλασική πόλη πού σχεδιάστηκε από τον γερμανό αρχιτε κτονα "Εντοναρντ Σάουμπερτ (1804-1860) και η σύγχρονη πόλη που κτίστηκε πάνω στά. σχέδια του τελευταίού. Κάθε ένα από αυτά τα στρώματα - αρχαία κατάλοιπα. νεοκλασικός πολεοδομικός ιστός και νεώτερα κτίσματα - γίνεται αντιληπτό στο πλαίσιο αυτού του πολεοδομικού συνόλου και βρίσκεται σε άμεση σχέση με τα άλλα δύο. Ηπαρονσίαση των αρχαιολογικών ερευνών, που ξεκινούν το 1436 με την αποκάλυψη τον αρχαιολογικού χώρού από τον Ciriaco de' Pizzicolli d'Ancona (Κυριάκος ο Αγκωνίτης) και συνεχίζονται συστηματικά. από περιηγητές_αρχαιολόγούς κατά το 19° αι., καλύπτει ένα κενό στην ιστοριογραφία της έρεύνας της αρχαίας πύλης. Η προσέγγιση αυτή φωτίζει επίσης τη στενή σχέσημεταξύαρχαιολογίας και πολεοδομίας κατά τον 190 αι. Αν η εξερεύνηση της Ελλάδος, ως την ανεξαρτησία της το 1827, ήταν έργο κνρϊως αρχαιολόγων, ιστορικών και φιλολόγων, μετά από αυτήν την χρονολογία., γεωλόγοι, μηχανικοί και τοπογράφοι που εργάζονταν για την οικονομική ανάπτυξη τον νεοσύστατου Ελληνικού Κράτούς, άρχισαν επίσης να περιτρέχονν όλη την χώρα., με το βλέμμα. στραμμένο όχι μόνο προς την Αρχαιότητα, αλλά και προς το μέλλον. Η ιστορία της αποκάλυψης της Ερέτριας φωτίζει έτσι και διάφορες όψεις που συνδέονται με την γένεση του Ελληνικού Κράτους. Το 1834, υ 'Εντοναρντ Σάουμπερτ εκπόνησε το σχέδιο μιας νεοκλασικής πόλης που Θα επικαθόταν στα; ερείπια. της αρχαίας Ερέτριας?το έργο εντάσσεται στο δίκτυο δημιουργίας νέων πόλεων και εκσυγχρονισμού των υπαρχυυσών από το νεοσύστατο Ελληνικό Κράτος. το οποίο, μετά την Οθωμανική κυριαρχία, επεδίωκε να Θεμελιώσει την νομιμότητα και την ταυτότητά του πάνω στις ιδανικές ή εξιδανικευμένες αξίες της κλασικής αρχαιότητας. Στο σχέδιο της πολεοδομικής ανάπτυξης της Ερέτριας, η στενή σχέση μεταξύ αρχαιολογίας και πολεοδομίας και, κατ επέκταση. οι σαφείς αναφορές στην Αρχαιότητα. είναι εμφανείς: ο Εντοναρντ Σάουμπερτ άρχισε σχεδιάζοντας στο τοπογραφικό τον όλα τα αρχαία. ερείπια, καταγράφοντας έτσι τις τότε αρχαιολογικές γνώσεις για, το χώρο. Σε αυτή τη βάση, ο αρχιτέκτονας συνέλαβε την νεοκλασική πόλη εντάσσοντας σε αυτήν τα κυριότερα αρχαία μνημεία, τα οποία χρησίμευαν ως οπτικά σημεία αναφοράς, ενώ συγχρόνως υλοποιούσαν την ιδεολογική σχέση της απόλύτης μοναρχίας με την Αρχαιότητα. Στην Ερέτρια, δυο βασικοί άξονες συνέδεαν το λιμάνι με την Ακρόπολη και τη Ναυτική Σχολή με το Αρχαίο Θέατρο. Η ένταξη αρχαίων ερειπίων σε ένα πολεοδομικό σχέδιο είχε ήδη πραγματοποιηθεί από τούς Σταμάτιο Κλεάνθη και'Εντουαρντ Σάουμπερτ στα 1831-1832, στον σχεδιασμό της νέας Αθήνας, πριν αυτή ανακηρυχθεί σε πρωτεύουσα. της Ελλάδος. Οι δυο αρχιτέκτονες προεξόφλησαν έτσι τον συμβολικό χαρακτήρα της Αθήνας στην διαδικασία. γένεσης του Ελληνικού Κράτούς, Η σημασία αυτού τον σχεδίου καθώς και εκείνου που συνέταξαν, πάνω στο ίδιο πνεύμα, για τον Πειραιά έχει αναγνωριστεί από τους σύγχρονούς πολεοδόμους. Αντίθετα, το σχέδιο της Ερέτριας, παρ όλο που ακολούθεί τις ίδιες αρχές, μελετήθηκε πολύ λίγο. Η παρούσα μονογραφία δείχνει ότι το σχέδιο της Ερέτριας ήταν το πιο ολοκληρωμένο από τα τρία. Βασικό χαρακτηριστικό των σχεδίων αυτών είναι ένα σύστημα οδών που αναπτύσσονται ακτινωτά από το κέντρο εξουσίας (βασιλική κατοικία στην Αθήνα και τον Πειραιά, δημαρχείο στην Ερέτρια). Αυτή η ακτινωτή διάταξη των οδών συμπεριλαμβάνει στην Αθήνα την Ακρόπολη και στον Πειραιά το λιμάνι, ενώ στην Ερέτρια είναι αμφίροπη, προσανατολισμένη, λόγω της τοπογραφίας, προς την ακρόπολη αλλά και προς τον όρμο του λιμανιού. Αυτή η διπλή ακτινωτή διάταξη από τη μια δημιούργεί τον ιδεολογικό δεσμό ιιε την Αρχαιότητα, ενώ από την άλλη τονίζει, με το άνοιγμά της προς το λιμάνι, την οικονομική άνθηση της πόλης που επιθυμούσε η κεντρική εξουσία. Τα σχέδιο της Ερέτριας αποτελεί αντιπροσωπευτικό δείγμα της προγραμματικής πολεοδομίας της Ελλάδος κατά τα, χρόνια της Βασιλείας του "Οθωνος (1832-1862). Η υλοποίηση του σχεδίου του Σάουμπερτ δεν ανταποκρίθηκε στις προσδοκίες της κυβέρνησης. Η μικρή ανάπτύξη της Ερέτριας οφείλεται κυρίως στούς ανεδαφικούς, μεγαλεπί βολονς στόχους του σχεδίού, στα μέτρια δημόσια οικονομικά, στην ενδημική ελονοσία λόγω των υφισταμένων ελών καθώς και σε μια, οικονομική πολιτική που ήταν ξένη στις εμπορικές παραδόσεις των Ψαριανών. Οι αργοί ρυθμοί της πραγματοποίησης του σχεδίού και μάλιστα κάποιες περικοπές τον κατά τη διάρκεια τον 19°ν και στις αρχές του 2θ αι., και στη συνέχεια η ταχεία πολεοδομική εξέλιξη της Ερέτριας από τη δεκαετία του 1960, είχαν σαν συνέπεια να υποτιμηθεί ή κατ να αγνοηθεί η ιστορική αξία του πολεοδομικού σχεδίου από τους ιστορικούς της πολεοδομίας. Ωστόσο, η εκτέλεση τον νεοκλασικού σχεδίου ακολουθήθηκε με συνέπεια, ενώ αναφορές στο σχέδιο του Σάουμπερτ μπορούν να παρατηρηθούν, ακόμα. και σήμερα. στις νεώτερες διευθετήσεις τον χώρου. Ετσι, στη δεκαετία του 1960, κατά μήκος του αρχαίού τείχούς της πόλης φυτεύθηκαν δέντρα, στη Θέση όπού ο Σάουμπερτ είχε προβλέψει τη δημιουργία ενός δεντροφυτεμένου περιπάτου. Στο κέντρο της Ερέτριας, εκεί όπου Θα έπρεπε να διαμορφωθεί η κύρια αγορά της πόλης, δημιουργήθηκε μια μεγάλη δημόσια πλατεία όπου γίνεται η εβδομαδιαία λαϊκή αγορά. Στην ανατολική συνοικία, χτίστηκε, το 2001, μια μικρή εκκλησία αφιερωμένη στην Παναγία, την Παραβοννιώτισσα, στο οικόπεδο όπου ο Σάουμπερτ είχε προβλέψει μια εκκλησία. Σημαντικά στοιχεία των σχεδίων του Σάουμπερτ, που δεν γίνονται πια καθόλου αντιληπτά στην ΑΘήνα και στον Πειραιά, μπορούν να παρατηρηθούν στην Ερέτρια. Το πράσινο, για παράδειγμα, καταλαμβάνει σημαντική Θέση τον ιδιωτικού χώρου: παρά την πύκνωση τον πολεοδομικού ιστού, χαρακτηριστικά είναι τα οικόπεδα που περιέχούν ακόμα μεμονωμένα σπίτια, μονώροφα ή διώροφα, επί προσώπου οδού, με ένα μεγάλο κήπο στο πίσω μέρος, που χωρίζονται από τα, γειτονικά οικόπεδα με ένα μαντρότοιχο πέτρινο ή από ωμές πλίνθους. Η Ερέτρια οφείλει λοιπόν να λάβει τη Θέση που της αξίζει στην ιστορία της Νεοελληνικής πολεοδομίας, εφόσον συμβάλλει στην καλύτερη κατανόηση των σχεδίων των δυο αυτών αδελφών πόλεων. Η μελέτη τον πολεοδομικού σχεδίού συμπληρώνεται από μια τυπολογική προσέγγιση των νεοκλασικών κτηρίων της Ερέτριας, η οποία υπογραμμίζει ακόμα περισσότερο την ιστορική αξία του συνόλου αυτού. Καθώς τα περισσότερα κτήρια απειλούνται με κατεδάφιση, με εξαίρεση λίγα από αυτά που είχαν την τύχη να συντηρούνται σωστά, μεταξύ 1994 και 2005, καταρτίστηκε ένα φωτογραφικό αρχείο των κτιρίων της Ερέτριας που χρονολογούνται στο 19° και στις αρχές τον 200υ αι., συμπληρωμένο και από παλιές φωτογραφίες. Από αυτό προκύπτει ότι οι μορφές κατ οι τεχνικές δομήσεως είναι αντιπροσωπευτικές της ιδιωτικής αρχιτεκτονικής κατά την εποχή της σύστασης τον Ελληνικού Κράτους. Τέλος, το γενικό ρυθμιστικό σχέδιο της Ερέτριας, που εκπονήθηκε στα 1975-1976 από μελετητική ομάδατης σχολής Αρχιτεκτόνων του Ομοσπονδιακού Πολυτεχνείου της Ζυρίχης, με την υποστήριξη της Ελβετικής Αρχαιολογικής Σχολής στην Ελλάδα., δημοσιεύεται εδώ για πρώτη φορά στην πλήρη μορφή του. Η παρούσα εργασία, αφορά ένα νεοκλασικό πολεοδομικό σύνολο, ταπεινό ίσως, αλλά αποτέλεσμα ενός φιλόδοξου πολεοδομικού σχεδιασμού, ο οποίος αποτελεί σημαντικό μάρτυρα του πολιτικού προγράμματος τον νεοσύστατού Ελληνικού Κράτους.

Attrition in the Swiss Household Panel

In this paper, we analyze magnitude and possible selectivity of attrition in first wave respondents in the Swiss Household Panel (SHP), from wave two (2000) through wave seven (2005). After comparing attrition of first wave respondents with that of other panel surveys, we proceed to model selectivity of attrition in two steps: we first build separate waveto- wave models, and second a longitudinal all-wave model. The latter model includes wave interaction effects. The first models allow for tracing of selectivity development, i.e. whether an initial selectivity might compensate or cumulates over time, the second to assessing the effects of the covariates in a specific wave, controlling for the base attrition effect. In particular it allows for the analysis of consequences due to discrete fieldwork events. Our results support the findings in the literature: attritors are in general the younger people and the males, foreigners, the socially and politically "excluded", i.e. those who show little social and political interest and participation, those who are mostly dissatisfied with various aspects in their life, and those who live in households with high unit nonresponse, and who exhibit a worse reporting behavior. This pattern is rather cumulative than compensating over panel waves. Excessive attrition in two waves presumably caused by two discrete events in the panel is not particularly selective. Still existing variation in selective attrition is worth to be further explored.

A controlled trial of the benefits of ultrasound-guided steroid injection for shoulder pain.

OBJECTIVES: We studied the value of ultrasound (US) to define shoulder pathology and guide local steroid injection in comparison with a standard injection in the management of the acute painful shoulder. METHODS: Seventy consecutive patients with acute shoulder pain were assessed clinically and by US. Patients were randomized to receive either a standard subacromial infiltration of 7 mg of betamethasone or a US-guided injection according to the US diagnosis. Follow-up evaluations were performed by an independent assessor who was blinded to the results of the initial US and clinical assessments. RESULTS: Sixty-seven patients completed the study. Both groups showed a significant reduction in both daytime and night pain compared to baseline. The US injection group had significantly less pain at rest at 2 and 6 weeks (NRS: 1.6 vs 3.3, P<0.005; 3 vs 4.2, P<0.04). The percentage of good responders was significantly higher in US group at 2 weeks, (81% vs 54%, P<0.005) and 6 weeks (64% vs 38%, P<0.05). At 2 and 6 weeks, responder rate and activity pain scores as well as Constant score were in favour of US, though did not reach statistical significance. CONCLUSION: Local steroid injection for shoulder pain leads to significant improvements in pain and function for up to 12 weeks. An US examination to define the origin of shoulder pain as well as to guide injection provides significant additional benefits for up to 6 weeks. We recommend routine US examination as part of the management of acute shoulder pain.

The return of increased blood pressure after discontinuation of antihypertensive treatment is associated with an impaired post-ischemic skin blood flow response.

OBJECTIVE: To assess the post-ischemic skin blood flow response after withdrawal of antihypertensive therapy in hypertensive patients with normal blood pressure during treatment. DESIGN AND METHODS: Twenty hypertensive patients (group A) with a normal clinic blood pressure (<140/ 90 mmHg) receiving antihypertensive treatment (any monotherapy; one pill per day for at least 6 months) had their treatment discontinued. Before medication withdrawal and 2, 4, 12 and 24 weeks thereafter, the following measurements were made: clinic blood pressure, home blood pressure (three times per week, morning and evening) and skin blood flow response to a 5 min forearm arterial occlusion (using laser Doppler flowmetry). The patients were asked to perform an ambulatory blood pressure recording at any time if home blood pressure was > or =160/95 mmHg on two consecutive days, and treatment was initiated again, after determination of the skin hyperemic response, if daytime ambulatory blood pressure was > or =140/90 mmHg. The same studies were performed in 20 additional hypertensive individuals in whom antihypertensive treatment was not withdrawn (group B). The allocation of patients to groups A and B was random. RESULTS: The data fom 18 patients in group A who adhered strictly to the procedure were available for analysis. Seven of them had to start treatment again within the first 4 weeks of follow-up; four additional patients started treatment again during the next 8 weeks (group A1). The seven other patients remained untreated (group A2). The skin hyperemic response decreased significantly in patients in group A1 and returned to baseline values at the end of the study, when there were again receiving antihypertensive treatment. In patients in group A2 a significant attenuation of the hyperemic response was also observed. This impaired response was present even at the end of the 6 month follow-up, at which time the patients were still untreated but exhibited a significantly greater blood pressure than before drug discontinuation. The hyperemic response of patients who did not stop treatment (group B) did not change during the course of the study. CONCLUSIONS: Our findings show a decrease in the postischemic skin blood flow response after withdrawal of antihypertensive treatment in hypertensive patients. This impaired response may be due to the development of endothelial dysfunction, vascular remodeling, or both, and might contribute to the return of blood pressure to hypertensive values after withdrawal of antihypertensive therapy.

Isolated office hypertension: a prehypertensive state?

OBJECTIVE AND METHOD: Isolated office hypertension, defined as hypertensive blood pressure values in a medical setting but normal self-measured or ambulatory-recorded blood pressures, is frequently encountered in clinical practice. Yet, whether this condition represents a transient state in the development of a sustained ambulatory hypertension is still unknown as no long-term analysis of the evolution of ambulatory blood pressure has been carried out in patients with isolated office hypertension. To evaluate whether such patients should be considered as truly normotensive or hypertensive, we have studied the long-term changes in office and ambulatory blood pressures in 81 patients in whom isolated office hypertension was observed between 1982 and 1988. RESULTS: After a 5-6 year follow-up, 60 of the 81 patients had a mean 12 h daytime ambulatory blood pressure greater than 140/90 mmHg, suggesting an evolution towards ambulatory hypertension. The development of hypertension could not be predicted on the basis of the follow-up office blood pressures as these tended to decrease during the follow-up period. CONCLUSIONS: The results of this study suggest that patients with isolated office hypertension should not be considered as truly normotensive individuals. Hence, these patients require a careful medical follow-up. Office blood pressure readings alone, however, do not appear to provide a good indicator of the long-term outcome of isolated office hypertension.

Epidemiologie der Osteoporose. [The epidemiology of osteoporosis].

Osteoporosis is characterized by low bone mass, micro architectural impairment of bone tissue, and a subsequent in crease in fracture risk. Fractures or the vertebrae and distal forearm, as well as the proximal femur, or hip fracture, are included. Hip fracture is associated with high mortality, morbidity and medical expenses. There is a dramatic increase in the incidence of hip fracture with age. Hip fracture incidence is 350 times higher in women aged 85 years and over comparatively to women between 35 and 44 years of age. In recent studies in Switzerland, it was observed that the annual age adjusted incidence rate of hip fracture was comparable with similar rates for white population in industrialized countries, although in men the rates were relatively high. Among the major risk factors for osteoporosis are age, female gender, white and Asian race, and menopause. Postmenopausal estrogen replacement therapy reduces bone resorption. Family history of osteoporosis, frail constitution, as well as excessive alcohol intake, cigarette smoking, chronic insufficient nutritional calcium intake and physical inactivity are other risk factors. A cardinal element is the peak bone mass reached in the third or fourth decade of life. Independently of osteoporosis, falls are a key agent in fractures; several medical conditions and drugs increase the risk of falling. There is an enormous social and financial cost of osteoporosis; the annual cost of medical treatment only for hip fracture is close to Fr. 200 million in Switzerland. The burden of osteoporosis is likely to increase in the future because of the demographic aging of the population unless large scale preventive interventions are undertaken.

New players driving inflammation in monogenic autoinflammatory diseases.

Systemic autoinflammatory diseases are caused by abnormal activation of the cells that mediate innate immunity. In the past two decades, single-gene defects in different pathways, driving clinically distinct autoinflammatory syndromes, have been identified. Studies of these aberrant pathways have substantially advanced understanding of the cellular mechanisms that contribute to mounting effective and balanced innate immune responses. For example, mutations affecting the function of cytosolic immune sensors known as inflammasomes and the IL-1 signalling pathway can trigger excessive inflammation. A surge in discovery of new genes associated with autoinflammation has pointed to other mechanisms of disease linking innate immune responses to a number of basic cellular pathways, such as maintenance of protein homeostasis (proteostasis), protein misfolding and clearance, endoplasmic reticulum stress and mitochondrial stress, metabolic stress, autophagy and abnormalities in differentiation and development of myeloid cells. Although the spectrum of autoinflammatory diseases has been steadily expanding, a substantial number of patients remain undiagnosed. Next-generation sequencing technologies will be instrumental in finding disease-causing mutations in as yet uncharacterized diseases. As more patients are reported to have clinical features of autoinflammation and immunodeficiency or autoimmunity, the complex interactions between the innate and adaptive immune systems are unveiled.