Negation and the functional sequence

There exists a general restriction on admissible functional sequences which prevents adjacent identical heads. We investigate a particular instantiation of this restriction in the domain of negation. Empirically, it manifests itself as a restriction the stacking of multiple negative morphemes. We propose a principled account of this restriction in terms of the general ban on immediately consecutive identical heads in the functional sequence on the one hand, and the presence of a Neg feature inside negative morphemes on the other hand. The account predicts that the stacking of multiple negative morphemes should be possible provided they are separated by intervening levels of structure. We show that this prediction is borne out

Recommendations for the design of laboratory studies on non-target arthropods for risk assessment of genetically engineered plants

This paper provides recommendations on experimental design for early-tier laboratory studies used in risk assessments to evaluate potential adverse impacts of arthropod-resistant genetically engineered (GE) plants on non-target arthropods (NTAs). While we rely heavily on the currently used proteins from Bacillus thuringiensis (Bt) in this discussion, the concepts apply to other arthropod-active proteins. A risk may exist if the newly acquired trait of the GE plant has adverse effects on NTAs when they are exposed to the arthropod-active protein. Typically, the risk assessment follows a tiered approach that starts with laboratory studies under worst-case exposure conditions; such studies have a high ability to detect adverse effects on non-target species. Clear guidance on how such data are produced in laboratory studies assists the product developers and risk assessors. The studies should be reproducible and test clearly defined risk hypotheses. These properties contribute to the robustness of, and confidence in, environmental risk assessments for GE plants. Data from NTA studies, collected during the analysis phase of an environmental risk assessment, are critical to the outcome of the assessment and ultimately the decision taken by regulatory authorities on the release of a GE plant. Confidence in the results of early-tier laboratory studies is a precondition for the acceptance of data across regulatory jurisdictions and should encourage agencies to share useful information and thus avoid redundant testing

The impacts of long-term flow reductions and an extreme drought on a large, permanently open estuary, and implications for setting the ecological reserve

Environmental water requirements (EWRs) are set for South Africa’s estuaries to ensure that they are maintained in a state that is both achievable and commensurate with their level of conservation and economic importance.  However, these EWRs are typically determined on the basis of models and scenario analyses that require extrapolation beyond existing data and experience, especially if climate change is considered.  In the case of the Berg Estuary, South Africa, available data on changes in freshwater flow and water quality span a period of at least five decades (1970s–present) during which significant reduction in flows has been observed.  Monitoring data also cover an extreme 3-year drought, from 2015−2017, which provided a unique opportunity to study the effects of severe freshwater starvation (zero-flow for an extended period) on this large, permanently open system.  Our analyses show that mean annual runoff (MAR) under present-day conditions has been reduced to around 50% of that under reference (natural) conditions and that reduction in runoff during the low-flow season (summer) has been more severe (80–86% reduction) than for the high-flow season (39–42% reduction).  The salinity gradient now extends much further upstream than under reference conditions.  Hypersaline conditions along with a reverse salinity gradient were recorded in the estuary for the first time ever during the drought of 2015/17.  Levels of dissolved inorganic nitrogen (NOx) reaching the estuary from the catchment have increased dramatically (6–7 fold) over the past five decades, dissolved reactive phosphate (PO4) slightly less so (2–3 fold), but ammonia (NH4) hardly at all.  Increases in nutrient input from the catchment in the high-flow season are also much more dramatic than in the low-flow season.  The estuary is no longer compliant with gazetted EWRs and requires urgent interventions to restore the quantity and quality of freshwater it receives. &nbsp

Applying the water-energy-food nexus to farm profitability in the Middle Breede Catchment, South Africa

The water-energy-food nexus has emerged as a useful concept to understand the multiple interdependencies that exist between the water, energy and food sectors. The nexus is an ambitious attempt to work across disciplines and scales to understand the workings of these complex systems. It is, however, criticised for being more of a general framework than a practical methodology because of the vast amount of data it would need to make real-life contributions to sustainable development. We show how the nexus approach, when used within a farm budget model, can transform the problem focus in water governance. By changing the relationship among water, energy and food production of a farm, profitability is significantly changed. The water-energy-food nexus debate is discussed within the context of the South African water sector, particularly the Breede River Catchment. Working from within the farm budget model, we demonstrate the impact of moving from an irrigation canal system that requires electricity for pumping, to a gravity-fed piped irrigation system in the Middle Breede River. The finding is that the water-energy-food nexus has the potential to unlock groundbreaking solutions to complex problems in agricultural water management when used in appropriate modelling systems.Significance: The water-energy-food nexus approach can lead to an entirely new framing of water governance problems and therefore solutions to these problems. The water-energy-food nexus when used in farm budget models can identify ways of altering farm profitability. By addressing the energy cost of farming through an irrigation pipeline system in parts of the Breede Catchment Area, farm profitability could significantly increase. A gravity-fed closed pipeline system in parts of the Breede River can improve water availability and reduce farm and management costs

Neonatal manifestation of multiple sulfatase deficiency

Busche A, Hennermann JB, Buerger F, et al. Neonatal manifestation of multiple sulfatase deficiency. EUROPEAN JOURNAL OF PEDIATRICS. 2009;168(8):969-973.Introduction Multiple sulfatase deficiency is biochemically characterized by the accumulation of sulfated lipids and acid mucopolysaccharides. Case report We report clinical, biochemical, and molecular findings in a female newborn affected with a severe form of multiple sulfatase deficiency (Mendelian Inheritance in Man (MIM) # 272200). She presented with primary microcephaly, facial anomalies including depressed nasal bridge, nasal hypoplasia, anteverted nostrils, smooth philtrum, limited mobility of hip and knee joints, mild ichthyosis, as well as muscular hypotonia. The diagnosis is based on detection of excessive mucopolysacchariduria and enzymatic assays performed in leucocytes which showed complete deficiency of all of the measured sulfatases. Sequencing of the coding region of the underlying gene, SUMF1, could not identify any mutation. However, failure to detect the corresponding mRNA by reverse transcription polymerase chain reaction proves defective SUMF1 expression. Conclusion The diagnosis of neonatal MSD should be considered when dealing with the association of distinct facial anomalies, limited joint mobility, ichthyosis, and muscular hypotonia

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London