bluuebunny/crossref_metadata_2025 huggingface dataset:
Future Climate Change in the Baltic Sea Region and Environmental Impacts
Authors: Räisänen Jouni
Published: December 2016

The warming of the global climate is expected to continue in the 21st century, although the magnitude of change depends on future anthropogenic greenhouse gas emissions and the sensitivity of climate to them. The regional characteristics and impacts of future climate change in the Baltic Sea countries have been explored since at least the 1990s. Later research has supported many findings from the early studies, but advances in understanding and improved modeling tools have made the picture gradually more comprehensive and more detailed. Nevertheless, many uncertainties still remain.

In the Baltic Sea region, warming is likely to exceed its global average, particularly in winter and in the northern parts of the area. The warming will be accompanied by a general increase in winter precipitation, but in summer, precipitation may either increase or decrease, with a larger chance of drying in the southern than in the northern parts of the region. Despite the increase in winter precipitation, the amount of snow is generally expected to decrease, as a smaller fraction of the precipitation falls as snow and midwinter snowmelt episodes become more common. Changes in windiness are very uncertain, although most projections suggest a slight increase in average wind speed over the Baltic Sea. Climatic extremes are also projected to change, but some of the changes will differ from the corresponding change in mean climate. For example, the lowest winter temperatures are expected to warm even more than the winter mean temperature, and short-term summer precipitation extremes are likely to become more severe, even in the areas where the mean summer precipitation does not increase.

The projected atmospheric changes will be accompanied by an increase in Baltic Sea water temperature, reduced ice cover, and, according to most studies, reduced salinity due to increased precipitation and river runoff. The seasonal cycle of runoff will be modified by changes in precipitation and earlier snowmelt. Global-scale sea level rise also will affect the Baltic Sea, but will be counteracted by glacial isostatic adjustment. According to most projections, in the northern parts of the Baltic Sea, the latter will still dominate, leading to a continued, although decelerated, decrease in relative sea level. The changes in the physical environment and climate will have a number of environmental impacts on, for example, atmospheric chemistry, freshwater and marine biogeochemistry, ecosystems, and coastal erosion. However, future environmental change in the region will be affected by several interrelated factors. Climate change is only one of them, and in many cases its effects may be exceeded by other anthropogenic changes.
Social Choice Theory and Legislative Institutions
Authors: Miller Nicholas R.
Published: December 2016

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of Politics. Please check back later for the full article.

Narrowly understood, social choice theory is a specialized branch of applied logic and mathematics that analyzes abstract objects called preference aggregation functions, social welfare functions, and social choice functions. But more broadly, social choice theory identifies, analyzes, and evaluates rules that may be used to make collective decisions. So understood, social choice is a subfield of the social sciences that examines what may be called “voting rules” of various sorts. While social choice theory typically assumes a finite set of alternatives over which voter preferences are unrestricted, the spatial model of social choice assumes that policy alternatives can be represented by points in a space of one or more dimensions, and that voters have preferences that are plausibly shaped by this spatial structure.

Social choice theory has considerable relevance for the study of legislative (as well as electoral) institutions. The concepts and tools of social choice theory make possible formal descriptions of legislative institutions such as bicameralism, parliamentary voting procedures, effects of decision rules (e.g., supramajority vs. simple majority rule and executive veto rules), sincere vs. strategic voting by legislators, agenda control, and other parliamentary maneuvers. Spatial models of social choice further enrich this analysis and raise additional questions regarding policy stability and change. Spatial models are used increasingly to guide empirical research on legislative institutions and processes.
Gothic Criminology
Authors: Greek Cecil
Published: December 2016

Gothic criminology was developed in the first decade of the 21st century as a postmodern theoretical model, incorporating elements from key criminological/sociological texts and themes embedded in various literature and film genres, with the goal of highlighting the continued existence of monstrous evil in its various modern permutations. As developed by Caroline (Kay) S. Picart and Cecil Greek, the perspective has been used to compare reel and real-world criminal activity, including, for example, male serial killers (metaphorically depicted as vampires), female serial killers such as Eileen Wuornos, dirty cops (interpreted as Golem), suicidal terrorists, societal responses to chaos-induced contemporary global evil (the Behemoth), and supernatural malevolent forces taking possession of human bodies. The potential usefulness of the theory in explaining other expressions of dystopic societal deviance and crime appears to be expanding.
Network Analyses and Nervous System Disorders
Authors: Medaglia John D. , Bassett Danielle S.
Published: December 2016

Network analyses in nervous system disorders involve constructing and analyzing anatomical and functional brain networks from neuroimaging data to describe and predict the clinical syndromes that result from neuropathology. A network view of neurological disease and clinical syndromes facilitates accurate quantitative characterizations and mathematical models of complex nervous system disorders with relatively simple tools drawn from the field of graph theory. Networks are predominantly constructed from in vivo data acquired using physiological and neuroimaging techniques at the macroscale of nervous system organization. Studies support the emerging view that neuropsychiatric and neurological disorders result from pathological processes that disrupt the brain’s economically wired small-world organization. The lens of network science offers theoretical insight into progressive neurodegeneration, neuropsychological dysfunction, and potential anatomical targets for interventions ranging from pharmacological agents to brain stimulation.
The Zulu Philosophers
Authors: Mokoena Hlonipha
Published: December 2016

This is an advance summary of a forthcoming article in the Oxford Research Encyclopedia of African History. Please check back later for the full article.

The fortunes of the Zulu language were dramatically changed in the early part of the 20th century through the introduction of a standardized orthography and the creation of vernacular as a school subject. This should have led to a flourishing of Zulu literature and to the emergence of a vibrant literary culture. This, for the most part, is not what occurred. Instead, the literature that emerged was in the form of textbooks, which were used in primary and high schools, and sometimes even at university level, to ostensibly teach first-language Zulu speakers about their own language and culture. This vernacularization of Zulu has had the effect of masking and occluding the 19th century roots of Zulu writing. In that earlier era, there was no governing authority to regulate what and who could write in the language, nor was there a clearly defined market for Zulu texts. In this space, dominance was mainly achieved through the printing press, and many mission stations and missionaries purchased and used these presses for such a purpose. What emerged was a trans-ethnic, regional, and sometimes international network of Zulu speakers who communicated with each other via the pages of bilingual newspapers that were themselves often printed at mission stations. These Zulu writers and their creative works have languished in archives for decades, and are yet to find their interpreters and translators. Thus, although much has been written about Zulu intellectuals from the 1930s onwards—B. W. Vilakazi, H. I. E Dhlomo, his brother R. R. R. Dhlomo, C. L. S. Nyembezi—there is a yawning paucity of scholarly writing on the literary cultures that preceded this formalization of a “Zulu canon.” What complicates the recovery of this pre-vernacularization literature is that its most ardent promoters and contributors were missionary scholars and linguists such as John William Colenso and Henry Callaway, whose enthusiasm for the language was often marred by their association with the colonial project of conversion and subjugation.
West African Cinema
Authors: McCall John C.
Published: December 2016

Motion picture technology developed at the dawn of the 20th century, just as the formal colonization of Africa was launched at the Berlin Conference of 1884–1885. While it took a few decades for cinema houses to spread in West Africa, by mid-century the colonial administrations began to use film as a means for conveying colonial culture to African subjects. For the British and French colonials, film was a means to shape public opinion. Both British and French colonial administrations criminalized indigenous filmmaking for fear of the subversive potential of anti-colonial messages—film communicated in one direction only. When West African nations became independent in the late 20th century, these restrictions vanished and Africans began to make films. This process played out differently in Francophone Africa than in Anglophone countries. France cultivated African filmmakers, sponsored training, and funded film projects. Talented and determined filmmakers in Anglophone Africa also struggled to produce celluloid films, but unlike their counterparts in former French colonies, they received little support from abroad. A significant number of excellent celluloid films were produced under this system, but largely in Francophone Africa. Though many of these filmmakers have gained global recognition, most remained virtually unknown in Africa outside the elite spaces of the FESPACO film festival and limited screenings at French embassies. Though West African filmmakers have produced an impressive body of high-quality work, few Africans beyond the intellectual elite know of Africa’s most famous films. This paradox of a continent with renowned filmmakers but no local film culture began to change in the 1990s when aspiring artists in Nigeria and Ghana began to make inexpensive movies using video technology. Early works were edited on VCRs, but as digital video technology advanced, this process of informal video production quickly spread to other regions. The West African video movie industry has grown to become one of the most prominent, diverse, and dynamic expressions of a pan-African popular culture in Africa and throughout the global diaspora.
Women and Apartheid
Authors: Healy-Clancy Meghan
Published: December 2016

Apartheid, the system of racial and ethnic separation introduced in South Africa in 1948, was a gendered project. The immediate goal of the white Afrikaner men who led the apartheid state was to control black men: to turn black men from perceived political and criminal threats into compliant workers. Under apartheid, African men would travel to work for whites in towns and on mines, but their homes would be in rural ethnic “reserves,” known as “homelands” or “Bantustans.” This vision depended on the labors of African women: while their men migrated to work, women were to maintain their families in the increasingly overcrowded and desolate countryside, reproducing the workforce cheaply while instilling a sense of ethnic difference in their children. “Coloured” (mixed-race) and Indian women were similarly charged with social reproduction on a shoestring, in segregated rural and urban areas. White women uniquely had the franchise and freedom of movement, but they were also constrained by sexually repressive laws.

Apartheid’s gendered vision of production and social reproduction faced continual resistance, and it ultimately failed. First, it failed because African women increasingly moved from rural areas to urban centers, despite laws limiting their mobility. Second, it failed because some women organized across ethnic and racial lines. They often organized as mothers, demanding a better world for a new generation. Both their nationally and internationally resonant campaigns—against pass laws, educational and health care inequities, police brutality, and military conscription—and the fact of their collective organization gradually undermined apartheid. Officials generally underestimated the power of women, and their contributions have continued to be under-appreciated since apartheid ended in 1994, because women’s political style emphasized personal and familial concerns. But because apartheid was premised on transforming how families lived, actions of women in fact undermined the system from its core.
Documenting Precolonial Trade in Africa
Authors: Chirikure Shadreck
Published: December 2016

Promoted by necessity, scarcity, and/or abundance, trade is one of the most essential cultural behaviors that promoted contact and exchange of ideas, commodities, and services between individuals and communities and variously transformed African societies of different regions and time periods. Anthropological, historical (including historical linguistics), and archaeological evidence points to the existence, on the one hand, of intra-African trade and, on the other, of external trade between Africa and those outside the continent. Traditionally, however, trade and exchange involving perishable and organic commodities such as grain and cattle have until now been very difficult to identify due to a lack of well-resolved documentation techniques. By comparison, some objects such as metal artifacts, glass beads, ceramics, and porcelain are pyrotechnological products, with a high survival rate that makes their trade and exchange easily visible archaeologically. Given the well-known regional differences across the continent, it is essential to combine multiple sources and techniques, in a multipronged way, to provide a dynamic picture of the mechanics of precolonial African trade and exchange of various time periods and geographies.
Women and Gender in French North Africa, 1830–1962
Authors: Clancy-Smith Julia
Published: December 2016

The workings of modern empire can better be viewed through the lens of gender because gendered hierarchies illuminate broad, intersecting aspects of the colonial project.

Community, kinship, household economies, religion, education, sexuality, social engineering, nationalism, and transnational reform movements were all inflected by imperial patriarchy in various guises. This perspective is especially rich for “French” North Africa (Algeria, Tunisia, and Morocco) from 1830 until 1962 since the region and its peoples were subjected to intense forms of “European” settler colonialism. From the start, the “woman question” assumed particularly fraught and contentious dimensions whose repercussions can be detected even today. Nevertheless, colonial North Africa did not represent a self-enclosed container. Transimperial and global processes shaped the sociopolitical terrain, and in turn. Policies, practices, and resistance in the Maghrib exerted a powerful torque far beyond its limits. Key to understanding women, gender, and settler colonialism is the state of the “archive,” the sprawling corpus of records, writings, words, things, and images left in an empire’s wake. The voices of women, children, and “ordinary” people, those labeled “the colonized,” have until recently been missing in conventional narratives. As Antoinette Burton observed, the archives themselves structure “the conceptual frameworks of women’s and gender history.” In the imperial historical context, the task of recuperating and restoring lost voices is all the more problematic, yet urgent. One might also add that the fundamental question is “whether ‘women’ is a category at all.”
Rock and Roll
Authors: Weisbard Eric
Published: December 2016

Rock and roll, a popular music craze of the mid-1950s, turned a loud, fast, and sexy set of sounds rooted in urban, black, working class, and southern America into the pop preference as well of suburban, white, young, and northern America. By the late 1960s, those fans and British counterparts made their own version, more politicized and experimental and just called rock—the summoning sound of the counterculture. Rock’s aura soon faded: it became as much entertainment staple as dissident form, with subcategories disparate as singer-songwriter, heavy metal, alternative, and “classic rock.” Where rock and roll was integrated and heterogeneous, rock was largely white and homogeneous, policing its borders. Notoriously, rock fans detonated disco records in 1979. By the 1990s, rock and roll style was hip-hop, with its youth appeal and rebelliousness; post‒baby boomer bands gave rock some last vanguard status; and suburbanites found classic rock in New Country. This century’s notions of rock and roll have blended thoroughly, from genre “mash-ups” to superstar performers almost categories unto themselves and new sounds such as EDM beats. Still, crossover moments evoke rock and roll; assertions of authenticity evoke rock. Because rock and roll, and rock, epitomize cultural ideals and group identities, their definitions have been constantly debated. Initial argument focused on challenging genteel, professional notions of musicianship and behavior. Later discourse took up cultural incorporation and social empowerment, with issues of gender and commercialism as prominent as race and artistry. Rock and roll promised one kind of revolution to the post-1945 United States; rock another. The resulting hope and confusion has never been fully sorted, with mixed consequences for American music and cultural history.
Martin Luther in the Ecumenical Movement
Authors: Wilson Sarah Hinlicky
Published: December 2016

It is by now a well-established fact that Martin Luther never intended to start a new church. He grounded his reforming and theological claims in the universally acknowledged canon of Scripture and decisions of the Early Church. Despite the fundamentally ecumenical intention of the Augsburg Confession and many overtures toward reconciliation, Luther and his colleagues were unable to reverse the divisive impact of their reforms. In the 20th century, however, the twin processes of establishing a worldwide Lutheran fellowship and participating in the nascent ecumenical movement after 1910 prompted Lutherans toward a fresh appreciation of Augsburg Confession, Article 7 and the universal quality of Luther’s theology. This can be seen already in the constituting assembly of the Lutheran World Convention in 1923, where Bishop Ludwig Ihmels made a case for Lutheran ecumenism on the grounds of Lutheranism’s cultural adaptability, commitment to the dogmas of the Ancient Church, and Christocentric focus. Lutherans were accordingly significant figures in the multilateral process during the first half of the 20th century, with Swedish archbishop Nathan Söderblom serving as head of Life and Work, and American Lutherans pushing for confessional rather than national membership in the World Council of Churches. The newly constituted Lutheran World Federation undertook its first theological study in the 1950s on the topic of “The Unity of the Church,” continuing to affirm a double commitment to Lutheran confessional identity and ecumenical reconciliation. Ecumenism underwent a dramatic change as a result of the new involvement of the Catholic Church following Vatican II, a change that suited Lutherans well. The new focus was on bilateral dialogue, resolving the specific difficulties between two churches. While ecumenical efforts have mostly been directed toward outlining areas of doctrinal consensus and removing obstacles to visible and structural unity, in certain dialogues the person and work of Luther himself has been at the center of the conversation. This can be seen most clearly in the dialogue with Catholics on the Reformation legacy, with the Eastern Orthodox prompting a reassessment of Luther’s teaching on union with Christ, and with Mennonites in narrating the painful history of Lutheran persecution of Anabaptists.
Martin Luther and Systematic Theology
Authors: Hinlicky Paul R.
Published: December 2016

A meta-argument is needed today to go forward in theology with Luther. For speaking of God, even in sophisticated ways, is a dangerous business that can lead astray. Theology is not in the Reformer’s mind an unambiguous good. But neither is silence an option, if God has spoken. If God has spoken, one is summoned, indeed, empowered to speak in response. In some distinction from the dialectical theology of the 20th century, which oscillates between the Word of God and the word of man, Luther employed a dialectic of the Word and the Spirit to organize theology. And if in the power of the Spirit one speaks in response to God’s Word about God, one must also speak with others about speech about God that accords with God’s speech. This discourse straddles the community of faith and the academy. Thus three orders of theological discourse—speech in God’s name, the church’s confession, and academic theology—can be sorted in order to facilitate Luther’s challenge to theology as a dangerous business fraught with peril. It must do so in a way that both retrieves his insight into the dialectic of Word and Spirit and also guards against Luther’s own failures, especially in academic theology, when invective supplanted dialogue.

Within the Trinitarian sequence of Word and Spirit, the performance of God’s gospel word, so that it is experienced by the alienated sinner as the event of God surpassing the wrath of his love to establish the mercy of his love, constitutes the primary theology for Luther. This is discovered in the biblical matrix of Christian faith where the Spirit births every believer. Thus the primary theology of the Bible, taken as gospel speech in God’s name, gives “true” knowledge of God “in Christ crucified”; this is known and acknowledged in secondary theological speech, including Luther’s own doctrinal production. But the articulate recognition of these two orders is the critical work of an academic theologian.

Luther is in principle critically dogmatic, and where he falls short of this standard, he can and may be corrected by his own academic standards. The case depends on (1) the Trinitarian interpretation of the dialectic of Word and Spirit as primary and secondary orders of theological knowledge, respectively, that are conscience-binding, church-uniting and context-independent, and (2) the differentiation of the former from the academic task in hermeneutics and critical thinking that is context-dependent and subject to nothing other than reason and persuasion.
Passives and Syntax
Authors: Alexiadou Artemis
Published: December 2016

Cross-linguistic differences in passive formation and the differences between verbal and adjectival passives reveal some of the core properties of the passive. In earlier stages of the Principles and Parameters framework, differences in both these domains were taken as evidence that the grammar has two distinct components to build passives, namely the lexicon and the syntax. This intuition can be restated by adopting the view that all passive formation is syntactic. Indeed, it has been posited that there are two syntactic domains to build passives, and these two domains correlate with distinct properties of passive formations within a language and across languages.
Relative Clauses in Syntax
Authors: de Vries Mark
Published: December 2016

A relative clause is a clausal modifier that relates to a constituent of the sentence, typically a noun phrase. This is the antecedent or “head” of the relative construction. What makes the configuration special is that the subordinate clause contains a variable that is bound by the head. For instance, in the English sentence Peter recited a poem that Anne liked, the object of the embedded verb liked is relativized. In this example, the relative clause is a restrictive property, and the possible reference of a poem is narrowed to poems that Anne likes. However, it is also possible to construct a relative clause non-restrictively. If the example is changed to Peter recited this poem by Keats, which Anne likes, the relative clause provides additional information about the antecedent, and the internal variable, here spelled out by the relative pronoun which, is necessarily coreferential with the antecedent.

Almost all languages make use of (restrictive) relative constructions in one way or another. Various strategies of building relative clauses have been distinguished, which correlate at least partially with particular properties of languages, including word order patterns and the availability of certain pronouns. Relative clauses can follow or precede the head, or even include the head. Some languages make use of relative pronouns, while others use resumptive pronouns, or simply leave the relativized argument unpronounced in the subordinate clause. Furthermore, there is cross-linguistic variation in the range of syntactic functions that can be relativized. Notably, more than one type of relative clause can be present in one language. Special types of relative constructions include free relatives (with an implied pronominal antecedent), cleft constructions, and correlatives.

There is an extensive literature on the structural analysis of relative constructions. Questions that are debated include: How can different subtypes be distinguished? How does the internal variable relate to the antecedent? How can reconstruction and anti-reconstruction effects be explained? At what structural level is the relative clause attached to the antecedent or the matrix clause?
Medical Social Work Development in Shanghai
Authors: Ji QingYing , Zhang Anao
Published: December 2016

This article offers an overview of medical social work development in Shanghai, China. The Chinese definition of medical social work is introduced, and its development in Shanghai is described. Both from a history and policy perspective, this article outlines the three stages of medical social work development in Shanghai chronologically while introducing relevant national policies for medical social work at each stage. Lessons learned from the past are summarized and reviewed. Finally, future directions for further development are discussed.
Bronchoscopy Safety in Patients With Chronic Obstructive Lung Disease
Authors: Bellinger Christina R. , Khan Irtaza , Chatterjee Arjun B. , Haponik Edward F.
Published: December 2016

Background:

Flexible bronchoscopy is a safe and minimally invasive diagnostic tool used by pulmonologists, but few studies have prospectively compared outcomes in patients with objectively defined obstructive lung disease to those without obstruction.

Methods:

We determined whether complications in patients undergoing moderate sedation bronchoscopy differ in those without obstruction compared with chronic obstructive pulmonary disease (COPD). We prospectively followed all patients undergoing moderate sedation bronchoscopy in an inpatient or outpatient setting.

Results:

Over 12 months, data were collected prospectively in 258 patients. A total o 151 patients had pulmonary function testing with classification of COPD according to GOLD Criteria. Sixty-seven of those patients (44%) had COPD: 6 mild (9%), 29 moderate (42%), 27 severe (41%), and 5 very severe (8%). COPD patients were more likely to receive outpatient inhaled corticosteroids and long-acting bronchodilators and anticholinergics (P<0.001) as would be clinically appropriate. Among all patients with COPD, there were 13% minor complications and 5% major complications, with no deaths. Respiratory complications occurred more often in patients with severe to very severe COPD (22%) compared with patients without COPD (6%) (P=0.018). When adjusted for age, body mass index, and use of home oxygen, this difference was still significant (P=0.045).

Conclusion:

Bronchoscopy is generally safe with few complications in most patients with COPD. Patients with objectively confirmed severe to very severe COPD had more frequent respiratory complications than patients without COPD. The risks were not prohibitively high, but should be taken into consideration for COPD patients undergoing moderate sedation flexible bronchoscopy.
Gene expression patterns associated with neurological disease in HIV infection
Authors: Sanna Pietro Paolo , Repunte-Canonigo Vez , Masliah Eliezer , Lefebvre Celine
Published: December 2016

To provide new insight into the pathogenesis of neurocognitive impairments (NCI) in HIV infection, we used the Gene Set Enrichment Analysis (GSEA) algorithm to analyze pathway dysregulations in gene expression profiles of HIV-infected patients with or without NCI and HIV encephalitis (HIVE). While HIVE was characterized by widespread inflammation and tissue damage, gene expression evidence of induction of interferon (IFN), cytokines and tissue injury was apparent in all brain regions studied before the emergence of NCI. Various degrees of white matter changes were present in all HIV-infected subjects and were the primary manifestation in patients with NCI in the absence of HIVE. The latter showed a distinct pattern of immune activation with induction of chemokines, cytokines, β-defensins, and limited IFN induction.

Altogether results indicate that significant neuroinflammation and neuronal suffering precede NCI. Patients with NCI without HIVE showed a predominantly white matter dysfunction with a distinct pattern of immune activation.
The primary motor cortex is critical for the retention of implicit sensorimotor adaptation
Authors: Leow Li-Ann , Marinovic Welber , Carroll Timothy J , Riek Stephan
Published: December 2016

Sensorimotor adaptation, or adaptation of movements to external perturbations, is thought to involve the primary motor cortex (M1). In addition to implicit error-driven remapping, explicit re-aiming strategies also contribute to sensorimotor adaptation. However, no studies to date have examined the role of M1 in implicit learning in isolation from explicit strategies. Because the application of explicit strategies requires time, it is possible to emphasise implicit learning by controlling the time available to prepare movement. Here, we examined the role of M1’s role in implicit adaptation to rotated visual feedback whilst suppressing the use of explicit re-aiming strategies by limiting movement preparation times to less than 350ms. Perturbing M1 activity via single-pulse TMS during adaptation to a 30 ° rotation of visual feedback did not alter the rate or extent of error compensation, but elicited poorer retention in post-adaptation trials with no perturbation. This work shows that M1 is critical in the retention of new visuomotor maps as a result of implicit adaptation to a perturbation in sensory feedback when strategic error correction processes are suppressed.

Highlights

Adaptation of movements to perturbations occurs through explicit and implicit processes.

Here, explicit strategies were suppressed by shortening movement preparation time.

Perturbing motor cortex (M1) with TMS selectively impaired retention but not acquisition of sensorimotor adaptation.

M1 plays a crucial role in retention of sensorimotor adaptation obtained via implicit learning.
Gastrointestinal carriage is a major reservoir ofK. pneumoniaeinfection in intensive care patients
Authors: Gorrie Claire L , Mirceta Mirjana , Wick Ryan R , Edwards David J , Strugnell Richard A , Pratt Nigel , Garlick Jill , Watson Kerrie , Pilcher David , McGloughlin Steven , Spelman Denis W , Jenney Adam W J , Holt Kathryn E
Published: December 2016

Background

Klebsiella pneumoniaeis an opportunistic pathogen and a leading cause of hospital-associated (HA) infections. Patients in intensive care units (ICUs) are particularly at risk, and outbreaks are frequently reported in ICUs.K. pneumoniaeis also part of the healthy human microbiome, providing a potential reservoir for HA infection. However, the frequency ofK. pneumoniaegut colonization and its contribution to HA infections are not well characterized.

Methods

We conducted one-year prospective cohort study of ICU patients. Participants (n=498) were screened for rectal and throat carriage ofK. pneumoniaeshortly after admission, and clinical information was extracted from hospital records.K. pneumoniaeisolated from screening swabs and clinical diagnostic samples were characterized using whole genome sequencing. Genomic and epidemiological data were combined to identify likely transmission events.

Results and Conclusions

K. pneumoniaecarriage frequencies were estimated at 6% (95% CI, 3%-8%) amongst ICU patients admitted direct from the community, and 19% (95% CI, 14% – 51%) amongst those who had recent contact with healthcare. Gut colonisation on admission was significantly associated with subsequentK. pneumoniaeinfection (infection risk 16% vs 3%, OR=6.9, p<0.001), and genome data indicated a match between carriage and infection isolates in most patients. Five likely transmission chains were identified, resulting in six infections (12% ofK. pneumoniaeinfections in ICU). In contrast, 49% ofK. pneumoniaeinfections were caused by a strain that was unique to the patient, and 48% of patients withK. pneumoniaeinfections who participated in screening were positive for prior colonisation. These data confirmK. pneumoniaecolonisation is a significant risk factor for subsequent infection in ICU, and indicate that half of allK. pneumoniaeinfections result from patients’ own microbiota. Screening for colonisation on admission could limit risk of infection in the colonised patient and others.
No evidence for a bovine mastitisEscherichia colipathotype
Authors: Leimbach Andreas , Poehlein Anja , Vollmers John , Göerlich Dennis , Daniel Rolf , Dobrindt Ulrich
Published: December 2016

Background

Escherichia colibovine mastitis is a disease of significant economic importance in the dairy industry. Molecular characterization of mastitis-associatedE. coli(MAEC) did not result in the identification of common traits. Nevertheless, a mammary pathogenicE. coli(MPEC) pathotype has been proposed suggesting virulence traits that differentiate MAEC from commensalE. coli. The present study was designed to investigate the MPEC pathotype hypothesis by comparing the genomes of MAEC and commensal bovineE. coli.

Results

We sequenced the genomes of eightE. coliisolated from bovine mastitis cases and six fecal commensal isolates from udder-healthy cows. We analyzed the phylogenetic history of bovineE. coligenomes by supplementing this strain panel with eleven bovine-associatedE. colifrom public databases. The majority of the isolates originate from phylogroups A and B1, but neither MAEC nor commensal strains could be unambiguously distinguished by phylogenetic lineage. The gene content of both MAEC and commensal strains is highly diverse and dominated by their phylogenetic background. Although individual strains carry some typicalE. colivirulence-associated genes, no traits important for pathogenicity could be specifically attributed to MAEC. Instead, both commensal strains and MAEC have very few gene families enriched in either pathotype. Only the aerobactin siderophore gene cluster was enriched in commensalE. coliwithin our strain panel.

Conclusions

This is the first characterization of a phylogenetically diverse strain panel including several MAEC and commensal isolates. With our comparative genomics approach we could not confirm previous studies that argue for a positive selection of specific traits enabling MAEC to elicit bovine mastitis. Instead, MAEC are facultative and opportunistic pathogens recruited from the highly diverse bovine gastrointestinal microbiota. Virulence-associated genes implicated in mastitis are a by-product of commensalism with the primary function to enhance fitness in the bovine gastrointestinal tract. Therefore, we put the definition of the MPEC pathotype into question and suggest to designate corresponding isolates as MAEC.
Acute cardiac support with intravenous milrinone promotes recovery from early brain injury in a murine model of severe subarachnoid haemorrhage
Authors: Mutoh Tomoko , Mutoh Tatsushi , Nakamura Kazuhiro , Yamamoto Yukiko , Tsuru Yoshiharu , Tsubone Hirokazu , Ishikawa Tatsuya , Taki Yasuyuki
Published: December 2016

Early brain injury/ischaemia (EBI) is a serious complication early after subarachnoid haemorrhage (SAH) that contributes to development of delayed cerebral ischaemia (DCI). This study aimed to determine the role of inotropic cardiac support using milrinone (MIL) on restoring acute cerebral hypoperfusion attributable toEBIand improving outcomes after experimentalSAH. Forty‐three male C57BL/6 mice were assigned to either sham surgery (SAH‐sham),SAHinduced by endovascular perforation plus postconditioning with 2% isoflurane (Control), orSAHplus isoflurane combined withMILwith and without hypoxia‐inducible factor inhibitor (HIF‐I) pretreatment. Cardiac output (CO) during intravenousMILinfusion (0.25‐0.75 μg/kg/min) between 1.5 and 2.5 hours afterSAHinduction was monitored with Doppler echocardiography. Magnetic resonance imaging (MRI)‐continuous arterial spin labelling was used for quantitative cerebral blood flow (CBF) measurements. Neurobehavioral function was assessed daily by neurological score and open field test.DCIwas analyzed 3 days later by determining infarction onMRI. Mild reduction of cardiac output (CO) and global cerebral blood flow (CBF) depression were notable early afterSAH.MILincreasedCOin a dose‐dependent manner (P<.001), which was accompanied by improved hypoperfusion, incidence ofDCIand functional recovery than Control (P<.05). The neuroprotective effects afforded byMILor Control were attenuated by hypoxia‐inducible factor (HIF) inhibition (P<.05). These results suggest thatMILimproves acute hypoperfusion by its inotropic effect, leading to neurobehavioral improvement in mice after severeSAH, in whichHIFmay be acting as a critical mediator.
The Persistence of Sperm and the Development of Time Since Intercourse (TSI) Guidelines in Sexual Assault Cases at Forensic Science Ireland, Dublin, Ireland
Authors: Casey David G. , Domijan Katarina , MacNeill Sarah , Rizet Damien , O'Connell Declan , Ryan Jennifer
Published: December 2016

The persistence of sperm using confirmatory microscopic analysis, the persistence of sperm with tails, time since intercourse (TSI) analysis, and results from the acid phosphatase (AP) reaction from approximately 5581 swabs taken from circa 1450 sexual assault cases are presented. The observed proportions of sperm in the vagina and anus declines significantly after 48 h TSI, and sperm on oral swabs were observed up to 15 h TSI. The AP reaction as a predictor of sperm on intimate swabs is questioned. All AP reaction times gave a low true positive rate; 23% of sperm‐positive swabs gave a negative AP reaction time. We show the AP reaction is an unsafe and an unreliable predictor of sperm on intimate swabs. We propose that TSI not AP informs precase assessment and the evaluative approach for sexual assault cases. To help inform an evaluative approach, TSI guidelines are presented.
Clinical outcomes of laparoscopic cholecystectomy with accidental gallbladder perforation
Authors: Usuba Teruyuki , Nyumura Yuya , Takano Yuki , Iino Toshio , Hanyu Nobuyoshi
Published: December 2016

Introduction

Accidental gallbladder perforation frequently occurs during laparoscopic cholecystectomy and may increase the risk of infection. However, the necessity of antimicrobial prophylaxis for these patients is unclear. The aim of this study was to examine the clinical outcomes and necessity of antimicrobial prophylaxis after laparoscopic cholecystectomy with gallbladder perforation.

Methods

One hundred patients who underwent laparoscopic cholecystectomy were divided into two groups: patients with gallbladder perforation (Group A, n = 37) and patients without perforation (Group B, n = 63). We compared the white blood cell count and C‐reactive protein level the day after the operation, the complication rates of systemic inflammatory response syndrome and surgical‐site infection, and postoperative hospital stay between the two groups. All patients received antimicrobial prophylaxis only once before the operation.

Results

There were significant differences in every variable with the exception of postoperative hospital stay. Group A had a higher risk of infection, but the postoperative clinical course of Group A was not inferior to that of Group B.

Conclusion

The clinical outcomes of patients with accidental gallbladder perforation were acceptable, and the use of antimicrobial prophylaxis once before the operation was sufficient.
The Invisible Discrimination Before Our Eyes: A Bioethical Analysis
Authors: Minerva Francesca
Published: December 2016

The goal of this article is to introduce a philosophical analysis of a widely neglected condition which affects between 3% and 18% of the population. People affected by this condition (which will be revealed later in the article) experience a lower level of wellbeing than the average population and are discriminated against in both their professional and their personal life. I will argue that this form of discrimination should be taken more seriously in philosophical debate and that social, legal and medical measures ought to be taken in order to improve the quality of life of people affected by this condition.
When is a Choice not a Choice? ‘Sham Offers’ and the Asymmetry of Adolescent Consent and Refusal
Authors: Manson Neil C.
Published: December 2016

In some jurisdictions there is a puzzling asymmetry between consent and refusal, where, for some kinds of treatment, the adolescent patient has the power to permit her own treatment but her refusal does not have the same kind of normative significance as refusal of treatment by a competent adult. In this journal I recently offered a clarification and defence of this asymmetry in terms of a paternalistic justification of the sharing of normative powers between adolescents and other parties. Lawlor (2016) offers a number of objections to this account. Three of his objections can be dealt with quickly. But one of them is much more challenging: the asymmetry of consent and refusal entails a practice of making sham offers (offers that purport to be responsive to the patient's choices, but which, in fact, are not). They do not really offer a choice at all. Genuine offers seem to require a commitment to be symmetrically responsive to whatever decision outcome is reached by the recipient of the offer. When we reflect upon the way that offers can be made in complex social contexts, where different parties have a ‘say’ in what ought to be done, the symmetry of responsiveness need not apply. Offers can be genuine, without being symmetrically responsive. Contrary to the seemingly plausible objection, the asymmetry of consent and refusal does not entail sham offers, or the offer of ‘sham choices’.
The Substance View: A Critique (Part 3)
Authors: Lovering Rob
Published: December 2016

In my articles ‘The Substance View: A Critique’ and ‘The Substance View: A Critique (Part 2),’ I raise objections to the substance view (naturally), a theory of intrinsic value and moral standing defended by a number of contemporary moral philosophers, including Robert P. George, Patrick Lee, Christopher Tollefsen, and Francis Beckwith. In part one of my critique of the substance view, I raise reductio‐style objections to the substance view's conclusion that the standard human fetus has the same intrinsic value and moral standing as the standard adult human being, among other human beings. In part two, I raise objections to some of the premises invoked in support of that conclusion. Here, in part three, I raise objections to Henrik Friberg‐Fernros's attempt to rebut some of the aforementioned objections.
Objection to Conscience: An Argument Against Conscience Exemptions in Healthcare
Authors: Giubilini Alberto
Published: December 2016

I argue that appeals to conscience do not constitute reasons for granting healthcare professionals exemptions from providing services they consider immoral (e.g. abortion). My argument is based on a comparison between a type of objection that many people think should be granted, i.e. to abortion, and one that most people think should not be granted, i.e. to antibiotics. I argue that there is no principled reason in favour of conscientious objection qua conscientious that allows to treat these two cases differently. Therefore, I conclude that there is no principled reason for granting conscientious objection qua conscientious in healthcare. What matters for the purpose of justifying exemptions is not whether an objection is ‘conscientious’, but whether it is based on the principles and values informing the profession. I provide examples of acceptable forms of objection in healthcare.
Consumer‐driven nutrient dynamics in freshwater ecosystems: from individuals to ecosystems
Authors: Atkinson Carla L. , Capps Krista A. , Rugenski Amanda T. , Vanni Michael J.
Published: December 2016

The role of animals in modulating nutrient cycling [hereafter, consumer‐driven nutrient dynamics (CND)] has been accepted as an important influence on both community structure and ecosystem function in aquatic systems. Yet there is great variability in the influence ofCNDacross species and ecosystems, and the causes of this variation are not well understood. Here, we review and synthesize the mechanisms behindCNDin fresh waters. We reviewed 131 articles onCNDpublished between 1973 and 1June 2015. The rate of new publications inCNDhas increased from 1.4 papers per year during 1973–2002 to 7.3 per year during 2003–2015. The majority of investigations are inNorthAmerica with many concentrating on fish. More recent studies have focused on animal‐mediated nutrient excretion rates relative to nutrient demand and indirect impacts (e.g. decomposition). We identified several mechanisms that influenceCNDacross levels of biological organization. Factors affecting the stoichiometric plasticity of consumers, including body size, feeding history and ontogeny, play an important role in determining the impact of individual consumers on nutrient dynamics and underlie the stoichiometry ofCNDacross time and space. The abiotic characteristics of an ecosystem affect the net impact of consumers on ecosystem processes by influencing consumer metabolic processes (e.g. consumption and excretion/egestion rates), non‐CNDsupply of nutrients and ecosystem nutrient demand. Furthermore, the transformation and transport of elements by populations and communities of consumers also influences the flow of energy and nutrients across ecosystem boundaries. This review highlights that shifts in community composition or biomass of consumers and eco‐evolutionary underpinnings can have strong effects on the functional role of consumers in ecosystem processes, yet these are relatively unexplored aspects ofCND. Future research should evaluate the value of using species traits and abiotic conditions to predict and understand the effects of consumers on ecosystem‐level nutrient dynamics across temporal and spatial scales. Moreover, new work inCNDshould strive to integrate knowledge from disparate fields of ecology and environmental science, such as physiology and ecosystem ecology, to develop a comprehensive and mechanistic understanding of the functional role of consumers. Comparative and experimental studies that develop testable hypotheses to challenge the current assumptions ofCND, including consumer stoichiometric homeostasis, are needed to assess the significance ofCNDamong species and across freshwater ecosystems.