Objectives: Stroke and TIA are recognized complications of acute herpes zoster (HZ). Herein, we evaluate HZ as a risk factor for cerebrovascular disease (stroke and TIA) and myocardial infarction (MI) in a UK population cohort.Methods: A retrospective cohort of 106,601 HZ cases and 213,202 controls, matched for age, sex, and general practice, was identified from the THIN (The Health Improvement Network) general practice database. Cox proportional hazard models were used to examine the risks of stroke, TIA, and MI in cases and controls, adjusted for vascular risk factors, including body mass index .30 kg/m 2 , smoking, cholesterol .6.2 mmol/L, hypertension, diabetes, ischemic heart disease, atrial fibrillation, intermittent arterial claudication, carotid stenosis, and valvular heart disease, over 24 (median 6.3) years after HZ infection. Conclusion: HZ is an independent risk factor for vascular disease in the UK population, particularly for stroke, TIA, and MI in subjects affected before the age of 40 years. In older subjects, better ascertainment of vascular risk factors and earlier intervention may explain the reduction in risk of stroke after HZ infection. Neurology ® 2014;83:e27-e33 GLOSSARY BMI 5 body mass index; GP 5 general practitioner; HZ 5 herpes zoster; HZO 5 herpes zoster ophthalmicus; ICD 5 International Classification of Diseases; MI 5 myocardial infarction; THIN 5 The Health Improvement Network; VZV 5 varicellazoster virus. ResultsHerpes zoster (HZ) is caused by varicella-zoster virus (VZV), a ubiquitous pathogen, which, after primary chickenpox in children, persists asymptomatically (latently) in the sensory ganglia, including the trigeminal ganglion. Reactivation of VZV from latency and translocation, via sensory nerve endings, to the skin where it replicates is associated with the characteristic HZ rash. 1 Both ischemic and hemorrhagic strokes have been described after HZ affecting the ophthalmic branch of the trigeminal nerve.2 In these patients, virus spreads transaxonally to cerebral arteries, via trigeminal and other ganglionic afferents.2 At autopsy, viral inclusions, DNA, and antigen present in cerebral arteries confirms that VZV vasculopathy in these patients is associated with stroke and TIA.2 Similar pathology has also been found in strokes and TIA, which follow HZ occurring at nonophthalmic sites and even in the absence of rash, raising the possibility that VZV is more widely implicated in the pathogenesis of cerebrovascular disease. 2,3 This possibility is supported by findings from a Taiwanese population study showing a 30% increase in the
Prosumers are households that are both producers and consumers of electricity. A prosumer has a grid-connected decentralized production unit and makes two types of exchanges with the grid: energy imports when the local production is insufficient to match the local consumption and energy exports when local production exceeds it. There exists two systems to measure the exchanges: a net metering system that uses a single meter to measure the balance between exports and imports and a net purchasing system that uses two meters to measure separately power exports and imports. Both systems are currently used for residential consumption. We build a model to compare the two metering systems. Under net metering, the price of exports paid to prosumers is implicitly set at the price of the electricity that they import. WeThe authors thank the FNRS and the Walloon Region (Grant TECR) for its financial support. They also thank P. Agrell and participants at the Mannheim Energy Conference, the BAAE conference held at CORE/Louvain-la-Neuve, the 65th congress of AFSE Nancy, the Energy Symposium at University of Barcelona, the third FAERE Conference in Bordeaux, the EARIE conference in Lisbon, the IIOC conference in Boston and the workshop on electricity demand at Université Paris-Dauphine for comments and I. Peere for English editing.
We study the possible implications of incentive schemes as a tool to promote efficiency in the management of universities. In this paper, we show that by designing internal financial rules which create yardstick competition for research funds, a multi-department university may induce better teaching quality and research, as compared to the performance of independent departments. r
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