Diskriminering i strävan efter objektivitet: en kvalitativ studie av domstolars upprätthållande av postkoloniala strukturer

Vad diskriminering är står att finna i diskrimineringslagen (2008:567) och innebär i generella termer att en person har missgynnats på grund utav könstillhörighet, sin etnicitet, sin religion, funktionshinder samt sexuell läggning. Diskrimineringen utgörs av att denna person förfördelas gentemot en annan person i en jämförbar situation. Så långt är diskrimineringsgrunderna tämligen klara, men vi ställde oss frågan vad den rättsliga argumentationen egentligen säger. För att skärskåda rättens argumentation har vi i detta arbete valt att använda oss utav en kvalitativ diskursanalys av sex stycken domar i diskrimineringsmål där samtliga som väckt talan inte har fått rätt i domstol. Studien kom att visa att domstolarna i målen präglades av ett traditionellt och förenklande arbetssätt där gamla kulturella skillnader och värderingar speglade domsluten, något som vi menar blir på bekostnad av ”den andra” kulturen, och därmed exkluderas ”avvikande personer” från majoritetsnormen. Detta väckte frågan om rättens syn på en jämförbar situation och allas likhet inför lagen vilket studiens resultat kommit att ifrågasätta

Decreased admissions and hospital costs with a neutral effect on mortality following lowering of the troponin T cutoff point to the 99th percentile

Background: The implementation of high-sensitivity cardiac troponin T (hs-cTnT) assays and a cutoff based on the 99th cTnT percentile in the evaluation of patients with suspected acute coronary syndrome has not been uniform due to uncertain effects on health benefits and utilization of limited resources. Methods: Clinical and laboratory data from patients with chest pain or dyspnea at the emergency de¬partment (ED) were evaluated before (n = 20516) and after (n = 18485) the lowering of the hs-cTnT cutoff point from 40 ng/L to the 99th hs-cTnT percentile of 14 ng/L in February 2012. Myocardial infarction (MI) was diagnosed at the discretion of the attending clinicians responsible for the patient. Results: Following lowering of the hs-cTnT cutoff point fewer ED patients with chest pain or dyspnea as the principal complaint were analyzed with an hs-cTnT sample (81% vs. 72%, p < 0.001). Overall 30-day mortality was unaffected but increased among patients not analyzed with an hs-cTnT sample (5.3% vs. 7.6%, p < 0.001). The MI frequency was unchanged (4.0% vs. 3.9%, p = 0.72) whereas admission rates decreased (51% vs. 45%, p < 0.001) as well as hospital costs. Coronary angiographies were used more frequently (2.8% vs. 3.3%, p = 0.004) but with no corresponding change in coronary interventions. Conclusions: At the participating hospital, lowering of the hs-cTnT cutoff point to the 99th percentile decreased admissions and hospital costs but did not result in any apparent prognostic or treatment benefits for the patients

Contrasting nitrogen fluxes in African tropical forests of the Congo Basin

The observation of high losses of bioavailable nitrogen (N) and N richness in tropical forests is paradoxical with an apparent lack of N input. Hence, the current concept asserts that biological nitrogen fixation (BNF) must be a major N input for tropical forests. However, well-characterized N cycles are rare and geographically biased; organic N compounds are often neglected and soil gross N cycling is not well quantified. We conducted comprehensive N input and output measurements in four tropical forest types of the Congo Basin with contrasting biotic (mycorrhizal association) and abiotic (lowland-highland) environments. In 12 standardized setups, we monitored N deposition, throughfall, litterfall, leaching, and export during one hydrological year and completed this empirical N budget with nitrous oxide (N2O) flux measurement campaigns in both wet and dry season and in situ gross soil N transformations using N-15-tracing and numerical modeling. We found that all forests showed a very tight soil N cycle, with gross mineralization to immobilization ratios (M/I) close to 1 and relatively low gross nitrification to mineralization ratios (N/M). This was in line with the observation of dissolved organic nitrogen (DON) dominating N losses for the most abundant, arbuscular mycorrhizal associated, lowland forest type, but in contrast with high losses of dissolved inorganic nitrogen (DIN) in all other forest types. Altogether, our observations show that different forest types in central Africa exhibit N fluxes of contrasting magnitudes and N-species composition. In contrast to many Neotropical forests, our estimated N budgets of central African forests are imbalanced by a higher N input than output, with organic N contributing significantly to the input-output balance. This suggests that important other losses that are unaccounted for (e.g., NOx and N-2 as well as particulate N) might play a major role in the N cycle of mature African tropical forests

Принципы лечения очаговой гиперплазии эндометрия в постменопаузе

МЕНОПАУЗАЭНДОМЕТРИЯ ГИПЕРПЛАЗИ

Lack of Neuronal IFN-β-IFNAR Causes Lewy Body- and Parkinson's Disease-like Dementia.

Neurodegenerative diseases have been linked to inflammation, but whether altered immunomodulation plays a causative role in neurodegeneration is not clear. We show that lack of cytokine interferon-β (IFN-β) signaling causes spontaneous neurodegeneration in the absence of neurodegenerative disease-causing mutant proteins. Mice lacking Ifnb function exhibited motor and cognitive learning impairments with accompanying α-synuclein-containing Lewy bodies in the brain, as well as a reduction in dopaminergic neurons and defective dopamine signaling in the nigrostriatal region. Lack of IFN-β signaling caused defects in neuronal autophagy prior to α-synucleinopathy, which was associated with accumulation of senescent mitochondria. Recombinant IFN-β promoted neurite growth and branching, autophagy flux, and α-synuclein degradation in neurons. In addition, lentiviral IFN-β overexpression prevented dopaminergic neuron loss in a familial Parkinson's disease model. These results indicate a protective role for IFN-β in neuronal homeostasis and validate Ifnb mutant mice as a model for sporadic Lewy body and Parkinson's disease dementia.Support to S.I.-N. was from Danish Council For Independent Research (DFF)-Medical Sciences, Alzheimer-forskningsfonden, Danish Multiple Sclerosis Society, Danish Cancer Society and Lundbeck Foundation. D.C.R. is a Wellcome Trust Principal Research Fellow.This is the final version of the article. It first appeared from Elsevier via http://dx.doi.org/10.1016/j.cell.2015.08.06

Consumer myopia, competition and the incentives to unshroud add-on information

This paper studies unshrouding decisions in a framework similar to Gabaix and Laibson (2006), but considers an alternative unshrouding mechanism where the impact of advertising add-on information depends on the number of unshrouding firms. We show that shrouding becomes less prevalent as the number of competing firms increases. With unshrouding costs a non-monotonic relationship between the number of firms and unshrouding may arise

Radiative Cooling in MHD Models of the Quiet Sun Convection Zone and Corona

We present a series of numerical simulations of the quiet Sun plasma threaded by magnetic fields that extend from the upper convection zone into the low corona. We discuss an efficient, simplified approximation to the physics of optically thick radiative transport through the surface layers, and investigate the effects of convective turbulence on the magnetic structure of the Sun's atmosphere in an initially unipolar (open field) region. We find that the net Poynting flux below the surface is on average directed toward the interior, while in the photosphere and chromosphere the net flow of electromagnetic energy is outward into the solar corona. Overturning convective motions between these layers driven by rapid radiative cooling appears to be the source of energy for the oppositely directed fluxes of electromagnetic energy.Comment: 20 pages, 5 figures, Solar Physics, in pres

In vivo Hypoxia and a Fungal Alcohol Dehydrogenase Influence the Pathogenesis of Invasive Pulmonary Aspergillosis

Currently, our knowledge of how pathogenic fungi grow in mammalian host environments is limited. Using a chemotherapeutic murine model of invasive pulmonary aspergillosis (IPA) and 1H-NMR metabolomics, we detected ethanol in the lungs of mice infected with Aspergillus fumigatus. This result suggests that A. fumigatus is exposed to oxygen depleted microenvironments during infection. To test this hypothesis, we utilized a chemical hypoxia detection agent, pimonidazole hydrochloride, in three immunologically distinct murine models of IPA (chemotherapeutic, X-CGD, and corticosteroid). In all three IPA murine models, hypoxia was observed during the course of infection. We next tested the hypothesis that production of ethanol in vivo by the fungus is involved in hypoxia adaptation and fungal pathogenesis. Ethanol deficient A. fumigatus strains showed no growth defects in hypoxia and were able to cause wild type levels of mortality in all 3 murine models. However, lung immunohistopathology and flow cytometry analyses revealed an increase in the inflammatory response in mice infected with an alcohol dehydrogenase null mutant strain that corresponded with a reduction in fungal burden. Consequently, in this study we present the first in vivo observations that hypoxic microenvironments occur during a pulmonary invasive fungal infection and observe that a fungal alcohol dehydrogenase influences fungal pathogenesis in the lung. Thus, environmental conditions encountered by invading pathogenic fungi may result in substantial fungal metabolism changes that influence subsequent host immune responses

Safety of the Deferral of Coronary Revascularization on the Basis of Instantaneous Wave-Free Ratio and Fractional Flow Reserve Measurements in Stable Coronary Artery Disease and Acute Coronary Syndromes

OBJECTIVES The aim of this study was to investigate the clinical outcomes of patients deferred from coronary revascularization on the basis of instantaneous wave-free ratio (iFR) or fractional flow reserve (FFR) measurements in stable angina pectoris (SAP) and acute coronary syndromes (ACS). BACKGROUND Assessment of coronary stenosis severity with pressure guidewires is recommended to determine the need for myocardial revascularization. METHODS The safety of deferral of coronary revascularization in the pooled per-protocol population (n = 4,486) of the DEFINE-FLAIR (Functional Lesion Assessment of Intermediate Stenosis to Guide Revascularisation) and iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome) randomized clinical trials was investigated. Patients were stratified according to revascularization decision making on the basis of iFR or FFR and to clinical presentation (SAP or ACS). The primary endpoint was major adverse cardiac events (MACE), defined as the composite of all-cause death, nonfatal myocardial infarction, or unplanned revascularization at 1 year. RESULTS Coronary revascularization was deferred in 2,130 patients. Deferral was performed in 1,117 patients (50%) in the iFR group and 1,013 patients (45%) in the FFR group (p <0.01). At 1 year, the MACE rate in the deferred population was similar between the iFR and FFR groups (4.12% vs. 4.05%; fully adjusted hazard ratio: 1.13; 95% confidence interval: 0.72 to 1.79; p = 0.60). A clinical presentation with ACS was associated with a higher MACE rate compared with SAP in deferred patients (5.91% vs. 3.64% in ACS and SAP, respectively; fully adjusted hazard ratio: 0.61 in favor of SAP; 95% confidence interval: 0.38 to 0.99; p = 0.04). CONCLUSIONS Overall, deferral of revascularization is equally safe with both iFR and FFR, with a low MACE rate of about 4%. Lesions were more frequently deferred when iFR was used to assess physiological significance. In deferred patients presenting with ACS, the event rate was significantly increased compared with SAP at 1 year. (C) 2018 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation.Peer reviewe