Ecologie et liberté : libéralisme versus républicanisme

La question centrale de ce travail est celle de la relation entre finitude environnementale et liberté individuelle. Par finitude environnementale il faut entendre l'ensemble des contraintes écologiques variées qui posent des limites à l'action humaine. Celles-ci sont de deux types généraux : les limites de disponibilité des ressources naturelles et: les limites de charge des écosystèmes et des grands cycles biogéochimiques globaux (chapitre 1). La thèse défendue ici est que les conceptions libertariennes et libérales de la liberté sont en conflit avec la nécessité de prendre en compte de telles limites et qu'une approche néo-républicaine est mieux à même de répondre à ces enjeux écologiques. Les théories libertariennes, de droite comme de gauche, sont inadaptées à la prise en compte de la finitude des ressources naturelles car elles maintiennent un droit à l'appropriation illimitée de ces dernières par les individus. Ce point est en contradiction avec le caractère systémique de la rareté et avec l'absence de substitut pour certaines ressources indispensables à la poursuite d'une vie décente (chapitres 2 et 3). La théorie libérale de la neutralité, appuyée par le principe du tort (harm principle), est quant à elle inadaptée à la prise en compte des problèmes environnementaux globaux comme le changement climatique. Les mécanismes causaux menant à la création de dommages environnementaux sont en effet indirects et diffus, ce qui empêche l'assignation de responsabilités au niveau individuel. La justification de politiques environnementales contraignantes s'en trouve donc mise en péril (chapitre 4). Ces difficultés proviennent avant tout de deux traits caractéristiques de ces doctrines : leur ontologie sociale atomiste et leur conception de la liberté comme liberté de choix. Le néo-républicanisme de Philip Pettit permet de répondre à ces deux problèmes grâce à son ontologie holiste et à sa conception de la liberté comme non- domination. Cette théorie permet donc à la fois de proposer une conception de la liberté compatible avec la finitude environnementale et de justifier des politiques environnementales exigeantes, sans que le sacrifice en termes de liberté n'apparaisse trop important (chapitre 5). - The centrai issue of this work is that of the relationship between environmental finiteness and individual liberty. By environmental finiteness one should understand the set of diverse ecological constraints that limit human action. These limits are of two general kinds: on the one hand the availability of natural resources, and on the other hand the carrying capacity of ecosystems and biogeochemical cycles (chapter 1}. The thesis defended here is that libertarian and liberal conceptions of liberty conflict with the necessity to take such limits into account, and that a neo-republican approach is best suited to address environmental issues. Libertarian theories, right-wing as well as left-wing, are in particular not able to take resource scarcity into account because they argue for an unlimited right of individuals to appropriate those resources. This point is in contradiction with the systemic nature of scarcity and with the absence of substitutes for some essential resources (chapters 2 and 3). The liberal doctrine of neutrality, as associated with the harm principle, is unsuitable when addressing global environmental issues like climate change. Causal mechanisms leading to environmental harm are indirect and diffuse, which prevents the assignation of individual responsibilities. This makes the justification of coercive environmental policies difficult (chapter 4). These difficulties stem above all from two characteristic features of libertarian and liberal doctrines: their atomistic social ontology and their conception of freedom as liberty of choice. Philip Pettit's neo- republicanism on the other hand is able to address these problems thanks to its holist social ontology and its conception of liberty as non-domination. This doctrine offers a conception of liberty compatible with environmental limits and theoretical resources able to justify demanding environmental policies without sacrificing too much in terms of liberty (chapter 5).

Subaortic ventricular septal defect closure: is the principle of harmony for a longer function no longer valid?

Comment on : Results of two different approaches to closure of subaortic ventricular septal defects in children. [Eur J Cardiothorac Surg. 2014]

Das Holprinzip in der Pädiatrie und Neonatologie [The collecting principle in pediatrics and neonatology]

Quality medical care during transport of critically ill pediatric and neonatal patients is only possible if the referring hospital and the regional center cooperate closely. The experience of physicians and nurses involved is of great importance, and the choice of the transporting team should depend on the medical status of the patient and the skills of the physicians and nurses or paramedics. Critically ill children and neonates should be transported by specialized teams. Our statistics from the last 12 years show an increasing number of transports, with the majority of patients being referred from peripheral hospitals.

Reversed shoulder arthroplasty baseplate fixed according to the major columns principle

Purpose Cadaveric study at our institution has demonstrated that optimal basaplate fixation of a reversed shoulder arthroplasty (RSA) could be achieved with screws in three major columns. Our aim was to review our early rate of aseptic glenoid loosening in a series of baseplate fixed according to this principle. Material and Methods Between 2005 and 2008, 48 RSA (Aequalis Reversed) were implanted in 48 patients with an average age of 74.4 years (range, 56 to 86 years). There were 37 women and 11 men. Twenty-seven primary RSAs were performed for cuff tear arthropathy, 3 after failed rotator cuff surgery, 6 for failed arthroplasties, 7 for acute fractures and 5 after failed ORIF. All baseplate fixation were done using a nonlocking posterior screw in the spine, a nonlocking anterior screw in the glenoid body, a locking superior screw in the coracoid and a locking inferior screw in the pillar. All patients were reviewed with standardized radiographs. The number of screws were reported. We measured the position of the screws in relation to the scapular spine and the coracoid process in two different views. We defined screw positions as totally, partially or out of the target. Finally we reported glenoid aseptic loosening which was defined as implant subsidence. Results Four patients were lost to follow-up. Thus, 44 shoulders could be reviewed after a mean follow-up of 13 months (range, 6 to 32 months). All baseplates were fixed with 4 screws. Thirty-seven (84%) screws were either partially or totally in the spine. Thus, 7 (16%) scapular spine screws were out of the target. No coracoid screw was out the target. Two (4.5%) patients had glenoid loosening. Both had a scapular spine and a coracoid screw partially in the bone. Conclusion Early aseptic glenoid loosening occurred before the two years follow-up and is most of time related to technical problems and/or insufficient bone stock and bone quality. Our study demonstrate that baseplate fixation according to the three columns principle is a reproducible technique and a valuable way to prevent early glenoid loosening.

Reversed shoulder arthroplasty baseplate fixed according to the three major columns principle

Introduction: Glenoid bone volume and bone quality can render the fixation of a reversed shoulder arthroplasty (RSA) basis plate hazardous. Cadaveric study at our institution has demonstrated that optimal baseplate fixation could be achieved with screws in three major columns. Our aim is to review our early rate of aseptic glenoid loosening in a series of baseplates fixed according to this principle. Methods: Between 2005 and 2008, 48 consecutive RSA (Reversed Aequalis) were implanted in 48 patients with an average age of 74.4 years (range, 56 to 86 years). There were 37 women and 11 men. Twenty-seven primary RSAs were performed for cuff tear arthropathy, 3 after failed rotator cuff surgery, 6 for failed arthroplasties, 7 for acute fractures and 5 after failed ORIF. All baseplate fixations were done using a nonlocking posterior screw in the scapular spine, a nonlocking anterior screw in the glenoid body, a locking superior screw in the coracoid and a locking inferior screw in the pillar. All patients were reviewed with standardized radiographs. We reported the positions of the screws in relation to the scapular spine and the coracoid process in two different views. We defined screw positions as totally, partially or out of the target. Finally, we reported aseptic glenoid loosening which was defined as implant subsidence. Results: Four patients were lost to follow-up. Thus 44 shoulders could be reviewed after a mean follow-up of 16 months (range, 9 to 32 months). Thirty-seven (84%) screws were either partially or totally in the spine. Thus, 7 (16%) scapular spine screws were out of the target. No coracoid screw was out of the target. At final follow-up control, we reported no glenoid loosening. Conclusion: Early glenoid loosening occurred before the two years follow-up and is most of time related to technical problems and/or insufficient glenoid bone stock and bone quality. Our study demonstrate that baseplate fixation of a RSA according to the three columns principle is a reproducible technique and a valuable way to prevent early glenoid loosening.

Hemoglobin enhances the biological activity of synthetic and natural bacterial (endotoxic) virulence factors: a general principle.

Although hemoglobin (Hb) is mainly present in the cytoplasm of erythrocytes (red blood cells), lower concentrations of pure, cell-free Hb are released permanently into the circulation due to an inherent intravascular hemolytic disruption of erythrocytes. Previously it was shown that the interaction of Hb with bacterial endotoxins (lipopolysaccharides, LPS) results in a significant increase of the biological activity of LPS. There is clear evidence that the enhancement of the biological activity of LPS by Hb is connected with a disaggregation of LPS. From these findings one questions whether the property to enhance the biological activity of endotoxin, in most cases proven by the ability to increase the cytokine (tumor-necrosis-factor-alpha, interleukins) production in human mononuclear cells, is restricted to bacterial endotoxin or is a more general principle in nature. To elucidate this question, we investigated the interaction of various synthetic and natural virulence (pathogenicity) factors with hemoglobin of human or sheep origin. In addition to enterobacterial R-type LPS a synthetic bacterial lipopeptide and synthetic phospholipid-like structures mimicking the lipid A portion of LPS were analysed. Furthermore, we also tested endotoxically inactive LPS and lipid A compounds such as those from Chlamydia trachomatis. We found that the observations made for endotoxically active form of LPS can be generalized for the other synthetic and natural virulence factors: In every case, the cytokine-production induced by them is increased by the addition of Hb. This biological property of Hb is connected with its physical property to convert the aggregate structures of the virulence factors into one with cubic symmetry, accompanied with a considerable reduction of the size and number of the original aggregates.

Spatial planning to the test of property rights in Switzerland : an innovative land management approach to coordinate spatial planning goals with property rights interests

In Switzerland, the land management regime is characterized by a liberal attitude towards the institution of property rights, which is guaranteed by the Constitution. Under the present Swiss constitutional arrangement, authorities (municipalities) are required to take into account landowners' interests when implementing their spatial planning policy. In other words, the institution of property rights cannot be restricted easily in order to implement zoning plans and planning projects. This situation causes many problems. One of them is the gap between the way land is really used by the landowners and the way land should be used based on zoning plans. In fact, zoning plans only describe how landowners should use their property. There is no sufficient provision for handling cases where the use is not in accordance with zoning plans. In particular, landowners may not be expropriated for a non-conforming use of the land. This situation often leads to the opening of new building areas in greenfields and urban sprawl, which is in contradiction with the goals set into the Federal Law on Spatial Planning. In order to identify legal strategies of intervention to solve the problem, our paper is structured into three main parts. Firstly, we make a short description of the Swiss land management regime. Then, we focus on an innovative land management approach designed to implement zoning plans in accordance with property rights. Finally, we present a case study that shows the usefulness of the presented land management approach in practice. We develop three main results. Firstly, the land management approach brings a mechanism to involve landowners in planning projects. Coordination principle between spatial planning goals and landowners' interests is the cornerstone of all the process. Secondly, the land use is improved both in terms of space and time. Finally, the institution of property rights is not challenged, since there is no expropriation and the market stays free.

A novel in vitro metabolomics approach for neurotoxicity testing, proof of principle for methyl mercury chloride and caffeine

There is a need for more efficient methods giving insight into the complex mechanisms of neurotoxicity. Testing strategies including in vitro methods have been proposed to comply with this requirement. With the present study we aimed to develop a novel in vitro approach which mimics in vivo complexity, detects neurotoxicity comprehensively, and provides mechanistic insight. For this purpose we combined rat primary re-aggregating brain cell cultures with a mass spectrometry (MS)-based metabolomics approach. For the proof of principle we treated developing re-aggregating brain cell cultures for 48h with the neurotoxicant methyl mercury chloride (0.1-100muM) and the brain stimulant caffeine (1-100muM) and acquired cellular metabolic profiles. To detect toxicant-induced metabolic alterations the profiles were analysed using commercial software which revealed patterns in the multi-parametric dataset by principal component analyses (PCA), and recognised the most significantly altered metabolites. PCA revealed concentration-dependent cluster formations for methyl mercury chloride (0.1-1muM), and treatment-dependent cluster formations for caffeine (1-100muM) at sub-cytotoxic concentrations. Four relevant metabolites responsible for the concentration-dependent alterations following methyl mercury chloride treatment could be identified using MS-MS fragmentation analysis. These were gamma-aminobutyric acid, choline, glutamine, creatine and spermine. Their respective mass ion intensities demonstrated metabolic alterations in line with the literature and suggest that the metabolites could be biomarkers for mechanisms of neurotoxicity or neuroprotection. In addition, we evaluated whether the approach could identify neurotoxic potential by testing eight compounds which have target organ toxicity in the liver, kidney or brain at sub-cytotoxic concentrations. PCA revealed cluster formations largely dependent on target organ toxicity indicating possible potential for the development of a neurotoxicity prediction model. With such results it could be useful to perform a validation study to determine the reliability, relevance and applicability of this approach to neurotoxicity screening. Thus, for the first time we show the benefits and utility of in vitro metabolomics to comprehensively detect neurotoxicity and to discover new biomarkers.

Testing the competitive exclusion principle using various niche parameters in a native (Natrix maura) and an introduced (N. tessellata) colubrid

Despite the increase of animal and plant introductions worldwide and the strong augmentation of the reptile trade, few invasive snake populations have been studied. Dice snakes (Natrix tessellata) were introduced to the shores of Lake Geneva (Switzerland) in the early 1920s, and are now well established. This region of introduction was previously inhabited by Viperine snakes (N. maura). Ever since these two species have been under monitoring (which began in 1996) the Viperine snake population has shown drastic decline. We examine here the possibility of trophic competition by analysing diet composition, prey size and trophic niche overlap. Spatial distribution is also assessed in order to address the question of spatial competitive exclusion. We found very similar diets, and thus a high trophic niche overlap, indicating no partitioning of the trophic resource. No arguments in favour of spatial competitive exclusion were found. Our study suggests that trophic competition may occur between the two natricines and that it may give an explanation for the drastic decline of the Viperine snake in this area. Other pathways potentially playing a role in the exclusion of the Viperine snake are discussed.