Treatment deviating from guidelines does not influence status epilepticus prognosis.

Status epilepticus (SE) prognosis is related to nonmodifiable factors (age, etiology), but the exact role of drug treatment is unclear. This study was undertaken to address the prognostic role of treatment adherence to guidelines (TAG). We prospectively studied over 26 months a cohort of adults with incident SE (excluding postanoxic). TAG was assessed in terms of drug doses (± 30 % of recommendations) and medication sequence; its prognostic impact on mortality and return to baseline conditions was adjusted for etiology, SE severity [Status Epilepticus Severity Score (STESS)], and comorbidities. Of 225 patients, 26 (12 %) died and 82 (36 %) were discharged with a new handicap; TAG was observed in 142 (63 %). On univariate analysis, age, etiology, SE severity, and comorbidities were significantly related to outcome, while TAG was associated with neither outcome nor likelihood of SE control. Logistic regression for mortality identified etiology [odds ratio (OR) 18.8, 95 % confidence interval (CI) 4.3-82.8] and SE severity (STESS ≥ 3; OR 1.7, 95 % CI 1.2-2.4) as independent predictors, and for lack of return to baseline, again etiology (OR 7.4, 95 % CI 3.9-14.0) and STESS ≥ 3 (OR 1.7, 95 % CI 1.4-2.2). Similar results were found for the subgroup of 116 patients with generalized-convulsive SE. Receiver operator characteristic (ROC) analyses confirmed that TAG did not improve outcome prediction. This study of a large SE cohort suggests that treatment adherence to recommendations using current medications seems to play a negligible prognostic role (class III), confirming the importance of the biological background. Awaiting further treatment trials, it appears mandatory to apply resources towards identification of new therapeutic approaches.

Hépatite B et migrants: doit-on mieux faire? [Hepatitis B and migrants: should we do better?].

More than 5% of the world's population lives with chronic hepatitis B. Migrants, particularly asylum seekers, are mostly from middle and high endemic regions. In Switzerland, however, no systematic screening of chronic hepatitis B is proposed to them. In a resolution published in 2010 the WHO encourages vaccination, but also screening of people at risk, as well as care of infected individuals. On the basis of a study conducted in asylum seekers in the canton of Vaud, prevalence of Ac antiHBc is estimated at 42% and HBsAg at 8%. Possible screening strategies and care are discussed in the light of these data. Identifying infected migrants would give them access to medical care and therefore lower the rate of complications, as well as the transmission of the virus between migrants and the local population.

The genome of the recently domesticated crop plant sugar beet (Beta vulgaris)

Sugar beet (Beta vulgaris ssp. vulgaris) is an important crop of temperate climates which provides nearly 30% of the world's annual sugar production and is a source for bioethanol and animal feed. The species belongs to the order of Caryophylalles, is diploid with 2n = 18 chromosomes, has an estimated genome size of 714-758 megabases and shares an ancient genome triplication with other eudicot plants. Leafy beets have been cultivated since Roman times, but sugar beet is one of the most recently domesticated crops. It arose in the late eighteenth century when lines accumulating sugar in the storage root were selected from crosses made with chard and fodder beet. Here we present a reference genome sequence for sugar beet as the first non-rosid, non-asterid eudicot genome, advancing comparative genomics and phylogenetic reconstructions. The genome sequence comprises 567 megabases, of which 85% could be assigned to chromosomes. The assembly covers a large proportion of the repetitive sequence content that was estimated to be 63%. We predicted 27,421 protein-coding genes supported by transcript data and annotated them on the basis of sequence homology. Phylogenetic analyses provided evidence for the separation of Caryophyllales before the split of asterids and rosids, and revealed lineage-specific gene family expansions and losses. We sequenced spinach (Spinacia oleracea), another Caryophyllales species, and validated features that separate this clade from rosids and asterids. Intraspecific genomic variation was analysed based on the genome sequences of sea beet (Beta vulgaris ssp. maritima; progenitor of all beet crops) and four additional sugar beet accessions. We identified seven million variant positions in the reference genome, and also large regions of low variability, indicating artificial selection. The sugar beet genome sequence enables the identification of genes affecting agronomically relevant traits, supports molecular breeding and maximizes the plant's potential in energy biotechnology.

The Same, but Different: Central Banks, Regulatory Agencies, and the Politics of Delegation to Independent Authorities

Independent regulatory agencies are the institutional foundations of the regulatory state that, during the past 15 years, has gained prominence throughout Europe. This article studies the rise of independent authorities in European countries by comparing regulatory agencies and central banks. Delegation to independent central banks and to independent regulatory agencies is similar in many respects. In both cases, agents are deliberately made independent from political principals through a specific institutional design. Moreover, it has been argued that delegation to both central banks and regulatory agencies is linked to the need for policy-makers to improve the credibility of policy commitments, to the wish of incumbent politicians to tie the hands of future majorities, and to the extent to which the institutional contexts safeguard policy stability. Through an analysis of the formal independence of central banks and regulatory agencies in Western Europe, this article identifies an empirical puzzle that casts doubts on the accuracy of current explanations. Veto players and the uncertainty of incumbent policy-makers in respect to their re-election prospects matter for delegation to both central banks and regulatory agencies, but in opposite ways. Making sense of these anomalies is necessary to achieve a better understanding of delegation to independent authorities.

Rééducation vasculaire du patient artériopathe [Vascular rehabilitation of patients suffering from peripheral arterial disease].

Rehabilitation programs represent an important and valuable tool for patients suffering various diseases. Supervised exercise programs for patients with peripheral arterial diseases have been shown to be efficacious in ameliorating walking performances and quality of life of such patients. With this regards the angiology service of the CHUV in Lausanne has established a multidisciplinary supervised program of vascular rehabilitation. This article describes organisation and characteristics of such a program.

Ultrasound assessment of ocular vascular effects of repeated intravitreal injections of ranibizumab for wet age-related macular degeneration.

PURPOSE: Determine the effect of repeated intravitreal injections of ranibizumab (0.5 mg; 0.05 ml) on retrobulbar blood flow velocities (BFVs) using ultrasound imaging quantification in twenty patients with exudative age-related macular degeneration treated for 6 months. METHODS: Visual acuity (ETDRS), central macular thickness (OCT), peak-systolic, end-diastolic and mean-BFVs in central retinal (CRA), temporal posterior ciliary (TPCA) and ophthalmic (OA) arteries were measured before, 2 days, 3 weeks and 6 months after the first injection. Patients were examined monthly and received 1-5 additional injections depending on ophthalmologic examination results. RESULTS: Six months after the first injection, a significant increase in visual acuity 50.9 ± 25.9 versus 44.4 ± 21.7 (p < 0.01) and decrease in mean central macular thickness 267 ± 74 versus 377 ± 115 μm (p < 0.001) were observed compared to baseline. Although mean-BFVs decreased by 16%±3% in CRA and 20%±5% in TPCA (p < 0.001) 2 days after the first injection, no significant change was seen thereafter. Mean-BFVs in OA decreased by 19%±5% at week 3 (p < 0.001). However, the smallest number of injections (two injections) was associated with the longest time interval between the last injection and month 6 (20 weeks) and with the best return to baseline levels for mean-BFVs in CRA, suggesting that ranibizumab had reversible effects on native retinal vascular supply after its discontinuation. Moreover, a significant correlation between the number of injections and percentage of changes in mean-BFVs in CRA was observed at month 6 (R = 0.74, p < 0.001) unlike TPCA or OA. CONCLUSION: Ranibizumab could impair the native choroidal and retinal vascular networks, but its effect seems reversible after its discontinuation.

Ability of different adiposity indicators to identify children with elevated blood pressure.

OBJECTIVE: Body composition measured by dual-energy X-ray absorptiometry (DXA) is believed to be superior to crude measures such as BMI or waist circumference (WC) to assess health risks associated with adiposity in adults. We compared the ability of BMI, WC, waist-to-height ratio (WHtR), percentage body fat from skinfold thickness, and measures of total and central fat assessed by DXA to identify children with elevated blood pressure (BP). STUDY DESIGN: The QUALITY Study follows 630 Caucasian families (father, mother, and child originally aged 8-10 years). BP, height, weight, WC, and skinfold thickness were measured according to standardized protocols. Elevated BP was defined as systolic or diastolic BP at least 90th age, sex, and height-specific percentile. Total and central fat were determined with DXA. The area under the receiver operating characteristic (ROC) curve (AUC) statistic was computed from logistic models that adjusted for age, sex, height, Tanner stage, and physical activity. RESULTS: All adiposity indicators were highly correlated. WC and WHtR did not show superior ability over BMI to identify children with elevated SBP (P = 0.421 and 0.473). Measures of total and central fat from DXA did not show an improved ability over BMI or WC to identify children with elevated SBP (P = 0.325-0.662). CONCLUSION: Results support the use of BMI in clinical and public health settings, at least in this age group. As all indicators had a limited ability to identify children with elevated BP, results also support measurement of BP in all children of this age independent of a weight status.

Uuden osakeyhtiölain verovaikutukset

Suomen uusi osakeyhtiölaki tuli voimaan 1.9.2006. Tutkielmassa on selvitetty uuden osakeyhtiölain keskeisimpiä vaikutuksia osakeyhtiöiden ja niiden osakkaiden verotukseen. Tutkielmassa on tarkasteltu uuden osakeyhtiölain nimellisarvotonta pääomajärjestelmää, varojenjakotapoja sekä yritysjärjestelytilanteita yhtiö- ja vero-oikeudelliselta kannalta. Valtiovarainministeriön asettama yritysverotuksen kehittämistyöryhmä on muistiossaan ehdottanut muutoksia verolakeihin uuden osakeyhtiölain vuoksi. Työryhmä on ehdottanut mm. osinkoverotuksen alaa ja peitellyn osingonjaonverottamista laajennettavaksi ja laittoman varojenjaon verotusta kiristettäväksi. Tutkielmassa on tarkasteltu työryhmän ehdotuksia ja pohdittu ehdotusten vaikutusta käytännön yritystoimintaan elinkeinoverolain näkökulmasta. Työryhmän ehdotukset eivät kuitenkaan kata kaikkia tilanteita. OYL:ssa mahdollistetut uudet yritysmuodonmuutos- ja yritysjärjestelytilanteet eivät toistaiseksi ole toteutettavissa veroneutraalisti. Verolainsäädännön joustamattomuuden vuoksi useat uuden lain mahdollistamattoimintavaihtoehdot eivät ole yhtiöiden käytettävissä. Muutoksia verolakeihin on odotettavissa aikaisintaan vuoden 2007 eduskuntavaalien jälkeen. Ennen verolakien uudistamista verotuskäytäntö on epävarmaa, mikä tehokkaasti estää uusien toimintamahdollisuuksien toteuttamisen.

Flandricismes, wallonismes et expressions impropres dans le langage français... ([Reprod.]) / par un ancien professeur

Collection : Archives de la linguistique française ; 327

Concentració parcel·lària de la zona regable del canal Segarra-Garrigues afectada per la xarxa Natura 2000 al nucli de La Figuerosa, terme municipal de Tàrrega (Urgell)

Aquest projecte final de carrera pretén realitzar la concentració parcel·lària d’una zona de 1.421,4476 hectàrees afectada per una zepa (zona especial de protecció d’aus) i que alhora és regable pel canal segarra-garrigues, al terme municipal de Tàrrega (Urgell), i més concretamente als voltants del nucli de la Figuerosa. La concentración parcel·lària és un procediment de reorganització de la propietat jurídica i pretén millorar la viabilitat económica de les explotacions, ja que moltes d’elles presenten nombroses parcel·les distribuïdes pel territorio. Alhora, la CP puposa ajustar l’estructura i dimensión de les finques i per tant els costos d’explotació dels propietaris beneficiats.