Neonatal enteral feeding tubes as loci for colonisation by members of the Enterobacteriaceae

Background The objective of this study was to determine whether neonatal nasogastric enteral feeding tubes are colonised by the opportunistic pathogen Cronobacter spp. (Enterobacter sakazakii) and other Enterobacteriaceae, and whether their presence was influenced by the feeding regime. Methods One hundred and twenty-nine tubes were collected from two neonatal intensive care units (NICU). A questionnaire on feeding regime was completed with each sample. Enterobacteriaceae present in the tubes were identified using conventional and molecular methods, and their antibiograms determined. Results The neonates were fed breast milk (16%), fortified breast milk (28%), ready to feed formula (20%), reconstituted powdered infant formula (PIF, 6%), or a mixture of these (21%). Eight percent of tubes were received from neonates who were 'nil by mouth'. Organisms were isolated from 76% of enteral feeding tubes as a biofilm (up to 107 cfu/tube from neonates fed fortified breast milk and reconstituted PIF) and in the residual lumen liquid (up to 107 Enterobacteriaceae cfu/ml, average volume 250 µl). The most common isolates were Enterobacter cancerogenus (41%), Serratia marcescens (36%), E. hormaechei (33%), Escherichia coli (29%), Klebsiella pneumoniae (25%), Raoultella terrigena (10%), and S. liquefaciens (12%). Other organisms isolated included C. sakazakii (2%),Yersinia enterocolitica (1%),Citrobacter freundii (1%), E. vulneris (1%), Pseudomonas fluorescens (1%), and P. luteola (1%). The enteral feeding tubes were in place between 48 h (13%). All the S. marcescens isolates from the enteral feeding tubes were resistant to amoxicillin and co-amoxiclav. Of additional importance was that a quarter of E. hormaechei isolates were resistant to the 3rd generation cephalosporins ceftazidime and cefotaxime. During the period of the study, K. pneumoniae and S. marcescens caused infections in the two NICUs. Conclusion This study shows that neonatal enteral feeding tubes, irrespective of feeding regime, act as loci for the bacterial attachment and multiplication of numerous opportunistic pathogens within the Enterobacteriaceae family. Subsequently, these organisms will enter the stomach as a bolus with each feed. Therefore, enteral feeding tubes are an important risk factor to consider with respect to neonatal infections

Observed and modeled Greenland ice sheet snow accumulation, 1958-2003, and links with regional climate forcing

Author Posting. © American Meteorological Society 2006. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Climate 19 (2006): 344–358, doi:10.1175/JCLI3615.1.Annual and monthly snow accumulation for the Greenland Ice Sheet was derived from ECMWF forecasts [mainly 40-yr ECMWR Re-Analysis (ERA-40)] and further meteorological modeling. Modeled accumulation was validated using 58 ice core accumulation datasets across the ice sheet and was found to be 95% of the observed accumulation on average, with a mean correlation of 0.53 between modeled and observed. Many of the ice core datasets are new and are presented here for the first time. Central and northern interior parts of the ice sheet were found to be 10%–30% too dry in ERA-40, in line with earlier ECMWF analysis, although too much (>50% locally) snow accumulation was modeled for interior southern parts of Greenland. Nevertheless, 47 of 58 sites show significant correlation in temporal variability of modeled with observed accumulation. The model also captures the absolute amount of snow accumulation at several sites, most notably Das1 and Das2 in southeast Greenland. Mean modeled accumulation over the ice sheet was 0.279 (standard deviation 0.034) m yr−1 for 1958–2003 with no significant trend for either the ice sheet or any of the core sites. Unusually high accumulation in southeast Greenland in 2002/03 leads the authors to study meteorological synoptic forcing patterns and comment on the prospect of enhanced climate variability leading to more such events as a result of global warming. There is good agreement between precipitation measured at coastal meteorological stations in southern Greenland and accumulation modeled for adjacent regions of the ice sheet. There is no significant persistent relation between the North Atlantic Oscillation index and whole or southern Greenland accumulation.JM acknowledges support from NASA’s Cryospheric Sciences Program and the Arctic Section of NSF’s Office of Polar Programs

Simple statistical probabilistic forecasts of the winter NAO

The variability of the North Atlantic Oscillation is a key aspect of Northern Hemisphere atmospheric circulation and has a profound impact upon the weather of the surrounding land masses. Recent success with dynamical forecasts predicting the winter NAO at lead times of a few months has the potential to deliver great socio-economic impacts. Here we find that a linear regression model can provide skillful predictions of the winter NAO based on a limited number of statistical predictors. Identified predictors include El-Niño, Arctic sea ice, Atlantic SSTs and tropical rainfall. These statistical models can show significant skill when used to make out-of-sample forecasts and we extend the method to produce probabilistic predictions of the winter NAO. The statistical hindcasts can achieve similar levels of skill to state-of the art dynamical forecast models, although out-of-sample predictions are less skillful, albeit over a small period. Forecasts over a longer out-of-sample period suggest there is true skill in the statistical models, comparable with that of dynamical forecasting models. They can be used both to help evaluate, and to offer insight into sources of predictability and limitations of, dynamical models

The Cold Peace: Russo-Western Relations as a Mimetic Cold War

In 1989–1991 the geo-ideological contestation between two blocs was swept away, together with the ideology of civil war and its concomitant Cold War played out on the larger stage. Paradoxically, while the domestic sources of Cold War confrontation have been transcended, its external manifestations remain in the form of a ‘legacy’ geopolitical contest between the dominant hegemonic power (the United States) and a number of potential rising great powers, of which Russia is one. The post-revolutionary era is thus one of a ‘cold peace’. A cold peace is a mimetic cold war. In other words, while a cold war accepts the logic of conflict in the international system and between certain protagonists in particular, a cold peace reproduces the behavioural patterns of a cold war but suppresses acceptance of the logic of behaviour. A cold peace is accompanied by a singular stress on notions of victimhood for some and undigested and bitter victory for others. The perceived victim status of one set of actors provides the seedbed for renewed conflict, while the ‘victory’ of the others cannot be consolidated in some sort of relatively unchallenged post-conflict order. The ‘universalism’ of the victors is now challenged by Russia's neo-revisionist policy, including not so much the defence of Westphalian notions of sovereignty but the espousal of an international system with room for multiple systems (the Schmittean pluriverse)

New insights into North European and North Atlantic surface pressure variability, storminess and related climate change since 1830

The authors present initial results of a new pan-European and international storminess since 1800 as interpreted from European and North Atlantic barometric pressure variability (SENABAR) project. This first stage analyzes results of a new daily pressure variability index, dp(abs)24, from long-running meteorological stations in Denmark, the Faroe Islands, Greenland, Iceland, the United Kingdom, and Ireland, some with data from as far back as the 1830s. It is shown that dp(abs)24 is significantly related to wind speed and is therefore a good measure of Atlantic and Northwest European storminess and climatic variations. The authors investigate the temporal and spatial consistency of dp(abs)24, the connection between annual and seasonal dp(abs)24 and the North Atlantic Oscillation Index (NAOI), as well as dp(abs)24 links with historical storm records. The results show periods of relatively high dp(abs)24 and enhanced storminess around 1900 and the early to mid-1990s, and a relatively quiescent period from about 1930 to the early 1960s, in keeping with earlier studies. There is little evidence that the mid- to late nineteenth century was less stormy than the present, and there is no sign of a sustained enhanced storminess signal associated with “global warming.” The results mark the first step of a project intending to improve on earlier work by linking barometric pressure data from a wide network of stations with new gridded pressure and reanalysis datasets, GCMs, and the NAOI. This work aims to provide much improved spatial and temporal coverage of changes in European, Atlantic, and global storminess

New insights into North European and North Atlantic surface pressure variability, storminess, and related climatic change since 1830

The authors present initial results of a new pan-European and international storminess since 1800 as interpreted from European and North Atlantic barometric pressure variability (SENABAR) project. This first stage analyzes results of a new daily pressure variability index, dp(abs)24, from long-running meteorological stations in Denmark, the Faroe Islands, Greenland, Iceland, the United Kingdom, and Ireland, some with data from as far back as the 1830s. It is shown that dp(abs)24 is significantly related to wind speed and is therefore a good measure of Atlantic and Northwest European storminess and climatic variations. The authors investigate the temporal and spatial consistency of dp(abs)24, the connection between annual and seasonal dp(abs)24 and the North Atlantic Oscillation Index (NAOI), as well as dp(abs)24 links with historical storm records. The results show periods of relatively high dp(abs)24 and enhanced storminess around 1900 and the early to mid-1990s, and a relatively quiescent period from about 1930 to the early 1960s, in keeping with earlier studies. There is little evidence that the mid- to late nineteenth century was less stormy than the present, and there is no sign of a sustained enhanced storminess signal associated with "global warming." The results mark the first step of a project intending to improve on earlier work by linking barometric pressure data from a wide network of stations with new gridded pressure and reanalysis datasets, GCMs, and the NAOI. This work aims to provide much improved spatial and temporal coverage of changes in European, Atlantic, and global storminess. © 2008 American Meteorological Society

Inferring the variation of climatic and glaciological contributions to West Greenland iceberg discharge in the twentieth century

Iceberg discharge is a major component of the mass balance of the Greenland Ice Sheet (GrIS). While bulk estimates of discharge variation over time exist, inferred remotely from measurements of grounding line ice velocities or surface mass balance calculations, few detailed measurements of discharge itself from individual marine-terminating glaciers existed until recent years. Recently, it has been shown, through a combination of ocean–iceberg modelling and non-linear system identification, that the century-long record of iceberg numbers crossing 48oN in the West Atlantic is a good first-order proxy for discharge from at least south and west Greenland. Here, we explore the varying relative importance of ice sheet, oceanic and climatic forcing of iceberg discharge from these areas over the twentieth century, by carrying out sensitivity studies of a non-linear auto-regressive mathematical model of the 48oN time series. We find that the relationships are mainly non-linear, with the contribution of the GrIS surface mass balance to iceberg discharge likely to be dominant in the first half of the century. This period is followed by several decades where oceanic temperature effects are most important in determining the model variation in iceberg discharge. In recent decades, all physical processes play a non-negligible part in explaining the iceberg discharge and the model suggests that the glacial response time to environmental changes may have decreased

The coexistence of peace and conflict in South America: toward a new conceptualization of types of peace

South America's predominant democratic regimes and its increasing interdependence on regional trade have not precluded the emergence of militarized crises between Colombia and Venezuela or the revival of boundary claims between Chile and Peru. This way, how can we characterize a zone that, in spite of its flourishing democracy and dense economic ties, remain involved in territorial disputes for whose resolution the use of force has not yet been discarded? This article contends that existing classifications of zones of peace are not adequate to explain this unusual coexistence. Thus, its main purpose is to develop a new analytical category of regional peace for assessing this phenomenon: the hybrid peace. It aims to research the evolution of security systems in South America during the previous century and build a new, threefold classification of peace zones: negative peace zones, hybrid peace zones, and positive peace zones