Molecular Identification of Mycobacterium Tuberculosis in the Milwaukee County Institution Grounds Cemetery

The possibility of identifying Mycobacterium tuberculosis in skeletal remains has been a debated topic for many years. This study utilizes the remains from the 1991 and 1992 excavations of the Milwaukee County Institution Grounds Cemetery, a collection of human skeletons ranging from 1882 to 1925, of various ages and sexes, to address that possibility. To test the utility of previously used methods of osteological identification of tuberculosis, the collection has been analyzed for the IS6110 repetitive element marker using molecular biological techniques, such as Polymerase Chain Reaction (PCR). Eighty-six skeletons from the collection have been analyzed, with nine of them showing evidence of skeletal tuberculosis. PCR has also been carried out with the oxyR marker to rule out Mycobacterium bovis contamination on all positive IS6110 samples. The goal of the study was to evaluate whether or not osteological identification of M. tuberculosis is possible and whether it can be confirmed using molecular biological techniques

The unintended consequences of the EU ETS cancellation policy

With the Phase 4 cancellation provision, the cumulative emissions cap of the EU ETS has become dependent on the amount of surplus allowances and future emissions abatement costs. In this paper, we discuss how the design of the market stability reserve greatly increases uncertainty over cumulative emissions and implies that there will be more cancellation when future abatement is more costly, making the policy more stringent when the cost of compliance is higher. Moreover, we illustrate how overlapping policies may lead to paradoxical effects on cumulative emissions

A review of pumped hydro energy storage development in significant international electricity markets

The global effort to decarbonise electricity systems has led to widespread deployments of variable renewable energy generation technologies, which in turn has boosted research and development interest in bulk Electrical Energy Storage (EES). However despite large increases in research funding, many electricity markets with increasingly large proportions of variable renewable generation have seen little actual bulk EES deployment. While this can be partly attributed to the need for technological developments, it is also due to the challenge of fairly rewarding storage operators for the range of services that storage provides to the wider network, especially in markets that have undergone significant restructuring and liberalisation. Pumped Hydroelectric Energy Storage (PHES) is the overwhelmingly established bulk EES technology (with a global installed capacity around 130 GW) and has been an integral part of many markets since the 1960s. This review provides an historical overview of the development of PHES in several significant electrical markets and compares a number of mechanisms that can reward PHES in different international market frameworks. As well as providing up-to-date information about PHES, a primary motivation for this work is to provide an overview about the types of rewards available to bulk EES for the wider storage community including investors, technology developers and policy-makers. Observing that bulk EES projects seem to be unattractive investments for the private sector, the paper also includes a brief discussion in terms of public sector investment

Comparing nuclear power trajectories in Germany and the UK: from ‘regimes' to ‘democracies’ in sociotechnical transitions and Discontinuities

This paper focuses on arguably the single most striking contrast in contemporary major energy politics in Europe (and even the developed world as a whole): the starkly differing civil nuclear policies of Germany and the UK. Germany is seeking entirely to phase out nuclear power by 2022. Yet the UK advocates a ‘nuclear renaissance’, promoting the most ambitious new nuclear construction programme in Western Europe.Here,this paper poses a simple yet quite fundamental question: what are the particular divergent conditions most strongly implicated in the contrasting developments in these two countries. With nuclear playing such an iconic role in historical discussions over technological continuity and transformation, answering this may assist in wider understandings of sociotechnical incumbency and discontinuity in the burgeoning field of‘sustainability transitions’. To this end, an ‘abductive’ approach is taken: deploying nine potentially relevant criteria for understanding the different directions pursued in Germany and the UK. Together constituted by 30 parameters spanning literatures related to socio-technical regimes in general as well as nuclear technology in particular, the criteria are divided into those that are ‘internal’ and ‘external’ to the ‘focal regime configuration’ of nuclear power and associated ‘challenger technologies’ like renewables. It is ‘internal’ criteria that are emphasised in conventional sociotechnical regime theory, with ‘external’ criteria relatively less well explored. Asking under each criterion whether attempted discontinuation of nuclear power would be more likely in Germany or the UK, a clear picture emerges. ‘Internal’ criteria suggest attempted nuclear discontinuation should be more likely in the UK than in Germany– the reverse of what is occurring. ‘External’ criteria are more aligned with observed dynamics –especially those relating to military nuclear commitments and broader ‘qualities of democracy’. Despite many differences of framing concerning exactly what constitutes ‘democracy’, a rich political science literature on this point is unanimous in characterising Germany more positively than the UK. Although based only on a single case,a potentially important question is nonetheless raised as to whether sociotechnical regime theory might usefully give greater attention to the general importance of various aspects of democracy in constituting conditions for significant technological discontinuities and transformations. If so, the policy implications are significant. A number of important areas are identified for future research, including the roles of diverse understandings and specific aspects of democracy and the particular relevance of military nuclear commitments– whose under-discussion in civil nuclear policy literatures raises its own questions of democratic accountability

Literacy Portfolios in Third Grade: A School-College Collaboration

In this article we will present our teacher professor collaborative investigation of the implementation of Literacy Portfolios (Hansen, 1992). We will discuss teacher professor collaborative research, Literacy Portfolios research, how our collaboration began, how we implemented Literacy Portfolios, our findings, implications for changes for the following year, and our reflections on our collaboration

Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD).

BACKGROUND: There has been renewal of interest in the use of prophylactic antibiotics to reduce the frequency of exacerbations and improve quality of life in chronic obstructive pulmonary disease (COPD). OBJECTIVES: To determine whether or not regular (continuous, intermittent or pulsed) treatment of COPD patients with prophylactic antibiotics reduces exacerbations or affects quality of life. SEARCH METHODS: We searched the Cochrane Airways Group Trials Register and bibliographies of relevant studies. The latest literature search was performed on 27 July 2018. SELECTION CRITERIA: Randomised controlled trials (RCTs) that compared prophylactic antibiotics with placebo in patients with COPD. DATA COLLECTION AND ANALYSIS: We used the standard Cochrane methods. Two independent review authors selected studies for inclusion, extracted data, and assessed risk of bias. We resolved discrepancies by involving a third review author. MAIN RESULTS: We included 14 studies involving 3932 participants in this review. We identified two further studies meeting inclusion criteria but both were terminated early without providing results. All studies were published between 2001 and 2015. Nine studies were of continuous macrolide antibiotics, two studies were of intermittent antibiotic prophylaxis (three times per week) and two were of pulsed antibiotic regimens (e.g. five days every eight weeks). The final study included one continuous, one intermittent and one pulsed arm. The antibiotics investigated were azithromycin, erythromycin, clarithromycin, doxycyline, roxithromycin and moxifloxacin. The study duration varied from three months to 36 months and all used intention-to-treat analysis. Most of the pooled results were of moderate quality. The risk of bias of the included studies was generally low.The studies recruited participants with a mean age between 65 and 72 years and mostly at least moderate-severity COPD. Five studies only included participants with frequent exacerbations and two studies recruited participants requiring systemic steroids or antibiotics or both, or who were at the end stage of their disease and required oxygen. One study recruited participants with pulmonary hypertension secondary to COPD and a further study was specifically designed to asses whether eradication of Chlamydia pneumoniae reduced exacerbation rates.The co-primary outcomes for this review were the number of exacerbations and quality of life.With use of prophylactic antibiotics, the number of participants experiencing one or more exacerbations was reduced (odds ratio (OR) 0.57, 95% CI 0.42 to 0.78; participants = 2716; studies = 8; moderate-quality evidence). This represented a reduction from 61% of participants in the control group compared to 47% in the treatment group (95% CI 39% to 55%). The number needed to treat for an additional beneficial outcome with prophylactic antibiotics given for three to 12 months to prevent one person from experiencing an exacerbation (NNTB) was 8 (95% CI 5 to 17). The test for subgroup difference suggested that continuous and intermittent antibiotics may be more effective than pulsed antibiotics (P = 0.02, I² = 73.3%).The frequency of exacerbations per patient per year was also reduced with prophylactic antibiotic treatment (rate ratio 0.67; 95% CI 0.54 to 0.83; participants = 1384; studies = 5; moderate-quality evidence). Although we were unable to pool the result, six of the seven studies reporting time to first exacerbation identified an increase (i.e. benefit) with antibiotics, which was reported as statistically significant in four studies.There was a statistically significant improvement in quality of life as measured by the St George's Respiratory Questionnaire (SGRQ) with prophylactic antibiotic treatment, but this was smaller than the four unit improvement that is regarded as being clinically significant (mean difference (MD) -1.94, 95% CI -3.13 to -0.75; participants = 2237; studies = 7, high-quality evidence).Prophylactic antibiotics showed no significant effect on the secondary outcomes of frequency of hospital admissions, change in forced expiratory volume in one second (FEV1), serious adverse events or all-cause mortality (moderate-quality evidence). There was some evidence of benefit in exercise tolerance, but this was driven by a single study of lower methodological quality.The adverse events that were recorded varied among the studies depending on the antibiotics used. Azithromycin was associated with significant hearing loss in the treatment group, which was in many cases reversible or partially reversible. The moxifloxacin pulsed study reported a significantly higher number of adverse events in the treatment arm due to the marked increase in gastrointestinal adverse events (P < 0.001). Some adverse events that led to drug discontinuation, such as development of long QTc or tinnitus, were not significantly more frequent in the treatment group than the placebo group but pose important considerations in clinical practice.The development of antibiotic resistance in the community is of major concern. Six studies reported on this, but we were unable to combine results. One study found newly colonised participants to have higher rates of antibiotic resistance. Participants colonised with moxifloxacin-sensitive pseudomonas at initiation of therapy rapidly became resistant with the quinolone treatment. A further study with three active treatment arms found an increase in the degree of antibiotic resistance of isolates in all three arms after 13 weeks treatment. AUTHORS' CONCLUSIONS: Use of continuous and intermittent prophylactic antibiotics results in a clinically significant benefit in reducing exacerbations in COPD patients. All studies of continuous and intermittent antibiotics used macrolides, hence the noted benefit applies only to the use of macrolide antibiotics prescribed at least three times per week. The impact of pulsed antibiotics remains uncertain and requires further research.The studies in this review included mostly participants who were frequent exacerbators with at least moderate-severity COPD. There were also older individuals with a mean age over 65 years. The results of these studies apply only to the group of participants who were studied in these studies and may not be generalisable to other groups.Because of concerns about antibiotic resistance and specific adverse effects, consideration of prophylactic antibiotic use should be mindful of the balance between benefits to individual patients and the potential harms to society created by antibiotic overuse. Monitoring of significant side effects including hearing loss, tinnitus, and long QTc in the community in this elderly patient group may require extra health resources

Exploring the role of phase-out policies for low-carbon energy transitions: the case of the German Energiewende

The energy sector plays a significant role in reaching the ambitious climate policy target of limiting the global temperature increase to well below 2°C. To this end, technological change has to be redirected and accelerated in the direction of zero-carbon solutions. Given the urgency and magnitude of the climate change challenge it has been argued that this calls for a policy mix which simultaneously supports low-carbon solutions and also deliberately drives the discontinuation of the established technological regime. Yet, the effect of such phase-out policies on the development and diffusion of low-carbon technologies has received little attention in empirical research so far. This paper addresses this gap by taking the case of the transition of the German electricity generation system towards renewable energies – the so-called Ener-giewende. Based on a survey of innovation activities of German manufacturers of renewable power gener-ation technologies conducted in 2014 it explores the impact such destabilization policies – most prominent-ly Germany’s nuclear phase-out policy – may have on technological change in renewable energies. By drawing on descriptive statistics and combining insights from earlier regression analyses we find evidence that Germany’s nuclear phase-out policy had a positive influence on manufacturers’ innovation expendi-tures for renewable energies and was seen as the by far most influential policy instrument for the further expansion of renewable energies in Germany. The insights resulting from our explorative analysis have important implications for the literature on policy mixes and sustainability transitions regarding the ‘flip sides’ to innovation and the crucial importance of destabilization policies for unleashing ‘destructive crea-tion’. We close by discussing policy repercussions for ongoing debates on policies for accelerating the phase-out of coal to meet climate change targets

Analysis of the influence of solar activity and atmospheric factors on Be-7 air concentration by seasonal-trend decomposition

7Be air concentrations were measured at the Universitat Politecnica de Valencia campus (in the east of Spain) during the period 2007e2014. The mean values of monthly 7Be concentrations ranged from 2.65 to 8.11 mBq/m3, showing significant intra and interannual variability. A seasonal-trend decomposition methodology was applied to identify the trend-cycle, seasonal and irregular components of the 7 Be time series. The decomposition model makes it possible to estimate the influence of solar activity and atmospheric factors on the independent components, in order to find the different sources of 7Be variability. The results show that solar activity is a factor with a high inverse influence on the trend cycle pattern of 7Be variability. Solar radiation, temperature and relative humidity are positive influential factors on the seasonal 7Be variation with a regular pattern over the years. Finally, the irregular component presents a significant negative correlation with precipitation and wind speed parameters, which have an irregular behavior over the years and seasons.This study has been supported partially by the REM program of the Nuclear Safety Council SRA/2071/2015/227.06 of Spain. We are also grateful to the UPV's weather station and the AEMET service for providing the atmospheric information used in this study.Bas Cerdá, MDC.; Ortiz Moragón, J.; Ballesteros Pascual, L.; Martorell Alsina, SS. (2016). Analysis of the influence of solar activity and atmospheric factors on Be-7 air concentration by seasonal-trend decomposition. Atmospheric Environment. 145:147-157. https://doi.org/10.1016/j.atmosenv.2016.09.027S14715714

Digital Health Solutions to Reduce the Burden of Atherosclerotic Cardiovascular Disease Proposed by the CARRIER Consortium

Digital health is a promising tool to support people with an elevated risk for atherosclerotic cardiovascular disease (ASCVD) and patients with an established disease to improve cardiovascular outcomes. Many digital health initiatives have been developed and employed. However, barriers to their large-scale implementation have remained. This paper focuses on these barriers and presents solutions as proposed by the Dutch CARRIER (ie, Coronary ARtery disease: Risk estimations and Interventions for prevention and EaRly detection) consortium. We will focus in 4 sections on the following: (1) the development process of an eHealth solution that will include design thinking and cocreation with relevant stakeholders; (2) the modeling approach for two clinical prediction models (CPMs) to identify people at risk of developing ASCVD and to guide interventions; (3) description of a federated data infrastructure to train the CPMs and to provide the eHealth solution with relevant data; and (4) discussion of an ethical and legal framework for responsible data handling in health care. The Dutch CARRIER consortium consists of a collaboration between experts in the fields of eHealth development, ASCVD, public health, big data, as well as ethics and law. The consortium focuses on reducing the burden of ASCVD. We believe the future of health care is data driven and supported by digital health. Therefore, we hope that our research will not only facilitate CARRIER consortium but may also facilitate other future health care initiatives