After Power - How and under which circumstances post-presidential power is applied

The President of the United States of America wields executive power like few other heads of state, in being commander-in-chief of the sole military and economic superpower within the international system. Yet after presidency, that hard power dissipates and is instead replaced by the ability to project soft power. In our paper we seek to understand this post-presidential power, the means through which a post-presidential actor can enact influence over others through their position as a former president. The actors in our study are former U.S. presidents Richard Nixon and Bill Clinton, whose power projections are contextualised by another previous head of state, former British Prime Minister Tony Blair. We conclude that the link between the post-presidency and soft power in our cases relies heavily on the pretexts in which the specific actor had as leader and which avenues they pursued to instigate power

Emission, fate and behaviour of phosphororganic flame retardants and plasticisers in the aquatic environment

Phosphororganic flame retardants and plasticisers are important contaminants in the aquatic environment. Whereas the non-chlorinated alkylphosphates were partly eliminated in wastewater treatment plants the amounts of the chlorinated flame retardants were hardly reduced. Thus these compounds are discharged into the aquatic environment by STP-effluents. The elimination efficiency of wastewater treatment depends on the one hand on the dimension of the respective STP and on the other hand on the treatment technique that is applied. The elimination was higher in larger STP (inhabitant equivalent values (IEV) 300,000-1,000,000) than in smaller ones (IEV below 100,000). Lower elimination rates were observed for the trickling filter plant that was sampled in comparison to the activated sludge plants. In degradation experiments of the selected organophosphates with activated sludge in batch reactors, bis-(2-chlorethyl) phosphate was identified as metabolite of tris-(2-chloroethyl) phosphate under aerobic conditions. The selected organophosphate esters were detected in surface water that is used for drinking water purification. Thus it was studied if the drinking water quality is affected by these compounds. For this purpose samples from different waterworks in the Ruhr catchment area were analysed. Moreover the elimination efficiency of diverse treatment processes such as slow sand filtration, ozonisation and activated carbon filtration was studied. In the finished water the concentrations of the organophosphates were below the respective limit of quantification (LOQ). The chlorinated alkylphosphates are very persistent in the aquatic environment as they have been detected and quantified in pristine waterbodies such as the German Bight and Lake Ontario. A reduction of these compounds in the German Bight was traced back to dilution effects only. The concentrations of the phosphororganic flame retardants in marine samples were one order of magnitude higher than for other contaminants such as herbicides and by-products of pesticide production. The non-chlorinated alkylphosphates have only been detected in the river Elbe plume. Similar results were obtained for samples of Lake Ontario. As expected from the respective log KOW values of the selected organophosphate esters the bioaccumulation of these substances in fish is low. The concentrations of tri-n-butylphosphate (TnBP), tri-iso-butylphosphate (TiBP), triphenylphosphate (TPP) and tris-(chloroisopropyl) phosphate TCPP in bream muscle from different sampling locations in Germany were in the lower ng/g range (dry weight). Tris-(chloroethyl) phosphate (TCEP), tris-(dichloroisopropyl) phosphate (TDCP), tris-(butoxyethyl) phosphate (TBEP) and ethylhexyldiphenylphosphate (EHDPP) were not detected in any fish sample. Moreover a temporal trend in the concentrations was observed. The sampling location seems to be an important factor that influences the detected levels of these substances in fish muscle as in the conurbation area higher amounts were detected than in riverine ecosystems. For the extraction of the selected organophosphate esters from water samples liquid-liquid extraction (LLE) and solid phase extraction (SPE) has been applied. Fish samples were extracted by accelerated solvent extraction (ASE) in combination with different clean up steps (SPE on silica gel and size exclusion chromatography (SEC)). The different compounds were detected by gas chromatography mass spectrometry with electron impact ionization (GC-EI-MS). For quantification purposes the isotopic labelled internal standards tri-n-butylphosphate d27 (TnBP d27) and triphenylphosphate d15 (TPP d15) were used. TPP d15 was synthesized from phenol d6 and phosphorus oxytrichloride. The empiric formula of the product was confirmed by electrospray high resolution time of flight mass spectrometry (ESI-HR-TOF-MS). The metabolites bis-(2-chloroethyl) phosphate (BCEP), bis-(methyl, 2-chloroethyl) phosphate (BCPP) and bis-(butoxyethyl) phosphate (BBEP) were synthesized from phosphorus oxytrichloride and the respective alcohols chloroethanol, 1-chloro-2-propanol and butoxyethanol. For the control of the reaction the respective products were measured after derivatisation with trimethylsulphoniumhydroxide (TMSH) by GC-EI-MS and gas chromatography positive chemical ionisation mass spectrometry (GC-PCI-MS)

A Case of Helicobacter cinaedi Bacteraemia in a Previously Healthy Person with Cellulitis

Helicobacter cinaedi is an infrequent, but well recognized cause of gastroenteritis in immunosuppressed patients. Here we report a case of an extra-intestinal infection in a previous healthy 61-year old heterosexual male. Focus for the infection was most likely cellulitis on the lower right leg. The bacterium was cultured from blood twice within one week. Electron microscopy of the isolate visualized bipolar flagella. Partial DNA sequencing of the 16S rRNA gene and phenotypic characterization of the isolate established the species diagnosis. The patient was treated with rifampicin. After end of treatment blood cultures were negative and the cellulitis had disappeared

Toric Intraocular Lenses in the Correction of Astigmatism During Cataract Surgery A Systematic Review and Meta-analysis

TopicWe performed a systematic review and meta-analysis to evaluate the benefit and harms associated with implantation of toric intraocular lenses (IOLs) during cataract surgery. Outcomes were postoperative uncorrected distance visual acuity (UCDVA) and distance spectacle independence. Harms were evaluated as surgical complications and residual astigmatism.Clinical RelevancePostoperative astigmatism is an important cause of suboptimal UCDVA and need for distance spectacles. Toric IOLs may correct for preexisting corneal astigmatism at the time of surgery.MethodsWe performed a systematic literature search in the Embase, PubMed, and CENTRAL databases within the Cochrane Library. We included randomized clinical trials (RCTs) if they compared toric with non-toric IOL implantation (± relaxing incision) in patients with regular corneal astigmatism and age-related cataracts. We assessed the risk of bias using the Cochrane Risk of Bias tool. We assessed the quality of evidence across studies using the GRADE profiler software (available at: www.gradeworkinggroup.org).ResultsWe included 13 RCTs with 707 eyes randomized to toric IOLs and 706 eyes randomized to non-toric IOLs; 225 eyes had a relaxing incision. We found high-quality evidence that UCDVA was better in the toric IOL group (logarithm of the minimum angle of resolution [logMAR] mean difference, −0.07; 95% confidence interval [CI], −0.10 to −0.04) and provided greater spectacle independence (risk ratio [RR], 0.51; 95% CI, 0.36–0.71) and moderate quality evidence that toric IOL implantation was not associated with an increased risk of complications (RR, 1.73; 95% CI, 0.60–5.04). Residual astigmatism was lower in the toric IOL group than in the non-toric IOL plus relaxing incision group (mean difference, 0.37 diopter [D]; 95% CI, −0.55 to −0.19).ConclusionsWe found that toric IOLs provided better UCDVA, greater spectacle independence, and lower amounts of residual astigmatism than non-toric IOLs even when relaxing incisions were used