29 research outputs found
Technoscientia est Potentia?: Contemplative, interventionist, constructionist and creationist idea(l)s in (techno)science
Within the realm of nano-, bio-, info- and cogno- (or NBIC) technosciences, the ‘power to change the world’ is often invoked. One could dismiss such formulations as ‘purely rhetorical’, interpret them as rhetorical and self-fulfilling or view them as an adequate depiction of one of the fundamental characteristics of technoscience. In the latter case, a very specific nexus between science and technology, or, the epistemic and the constructionist realm is envisioned. The following paper focuses on this nexus drawing on theoretical conceptions as well as empirical material. It presents an overview of different technoscientific ways to ‘change the world’—via contemplation and representation, intervention and control, engineering, construction and creation. It further argues that the hybrid character of technoscience makes it difficult (if not impossible) to separate knowledge production from real world interventions and challenges current science and technology policy approaches in fundamental ways
Assessing the effects of mosquito nets on malaria mortality using a space time model: a case study of Rufiji and Ifakara Health and Demographic Surveillance System sites in rural Tanzania
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
Identification and Differentiation of \u3ci\u3eTilletia indica\u3c/i\u3e and \u3ci\u3eT. walkeri\u3c/i\u3e Using the Polymerase Chain Reaction
Karnal bunt of wheat, caused by Tilletia indica, was found in regions of the southwestern United States in 1996. Yield losses due to Karnal bunt are slight, and the greatest threat of Karnal bunt to the U.S. wheat industry is the loss of its export market. Many countries either prohibit or restrict wheat imports from countries with Karnal bunt. In 1997, teliospores morphologically resembling T. indica were isolated from bunted ryegrass seeds and wheat seed washes. Previously developed PCR assays failed to differentiate T. indica from the recently discovered ryegrass pathogen, T. walkeri. The nucleotide sequence of a 2.3 kb region of mitochondrial DNA, previously amplified by PCR only from T. indica, was determined for three isolates of T. indica and three isolates of T. walkeri. There was greater than 99% identity within either the T. indica group or the T. walkeri group of isolates, whereas there was »3% divergence between isolates of these two Tilletia species. Five sets of PCR primers were made specific to T. indica, and three sets were designed specifically for T. walkeri based upon nucleotide differences within the mitochondrial DNA region. In addition, a 212 bp amplicon was developed as a target sequence in a fluorogenic 5¢ nuclease PCR assay using the TaqMan system for the detection and discrimination of T. indica and T. walkeri
Problem-Based Learning: the Emergence of New Scripts and Roles for Teachers to Render Epistemic Practices Transparent
Organising the machine: material-discursive practices and mobile medical equipment engineers
Scientific Nonknowledge and Its Political Dynamics: The Cases of Agri-Biotechnology and Mobile Phoning
While in the beginning of the environmental debate, conflicts over environmental and technological issues had primarily been understood in terms of "risk", over the past two decades the relevance of ignorance, or nonknowledge, was emphasized. Referring to this shift of attention to nonknowledge the article presents two main findings: first, that in debates on what is not known and how to appraise it different and partly conflicting epistemic cultures of nonknowledge can be discerned and, second, that drawing attention to nonknowledge in technology conflicts results in significant institutional effects and new constellations of actors in public debates. To illustrate and substantiate this political dynamics of nonknowledge we draw upon examples from the areas of agri-biotechnology and mobile phoning. In a first step, we develop in greater detail the concept of scientific cultures of nonknowledge and identify three such cultures involved in the social conflicts within the two areas. Subsequently, we analyze the specific dynamics of the politicisation of nonknowledge looking at the variety of actors involved and the pluralisation of perceptions and evaluations of what is not known. Then, we point out some of the institutional reactions to the political and cultural dynamics of scientific nonknowledge. We argue that the equal recognition of the diverse cultures of nonknowledge is a key prerequisite for socially legitimate and "robust" decision-making under conditions of politicised scientific nonknowledge. © The Author(s) 2010