Interdependent policy instrument preferences: a two-mode network approach

In policymaking, actors are likely to take the preferences of others into account when strategically positioning themselves. However, there is a lack of research that conceives of policy preferences as an interdependent system. In order to analyse interdependencies, we link actors to their policy preferences in water protection, which results in an actor-instrument network. As actors exhibit multiple preferences, a complex two-mode network between actors and policies emerges. We analyse whether actors exhibit interdependent preference profiles given shared policy objectives or social interactions among them. By fitting an exponential random graph model to the actor-instrument network, we find considerable clustering, meaning that actors tend to exhibit preferences for multiple policy instruments in common. Actors tend to exhibit interdependent policy preferences when they are interconnected, that is, they collaborate with each other. By contrast, actors are less likely to share policy preferences when a conflict line divides them

Psychische Belastung, Alkoholabhängigkeit und Rauchen

Die Prävalenz des Tabakkonsums ist bei Personen mit einer Neigung zur Depression höher als in der Allgemeinbevölkerung. Gleiches gilt für Personen mit einer Erkrankung aus dem schizophrenen Formenkreis. Alkoholabhängige Patienten weisen eine höhere psychische Belastung auf als nichtabhängige Personen. Bislang ungeklärt ist, inwiefern sich die rauchenden von den nichtrauchenden alkoholabhängigen Personen hinsichtlich ihrer psychischen Belastung unterscheiden. Es wurden Daten von 1403 Patienten mit der Hauptdiagnose „Alkoholabhängigkeit“ aus 40 Suchtrehabilitationskliniken zu Beginn der stationären Behandlung erhoben. 84% der Stichprobe sind Raucher. Die Messung der subjektiv empfundenen psychischen Symptombelastung erfolgte mittels der neun Skalen des Brief Symptom Inventory (BSI). Innerhalb der untersuchten Population der alkoholabhängigen Patienten weisen die zusätzlich rauchenden Patienten in den Bereichen Zwanghaftigkeit (T-Werte: 58 vs. 55), Depressivität (T-Werte: 64 vs. 61), Aggressivität (T-Werte: 59 vs. 55) und Psychotizismus (T-Werte: 63 vs. 59) signifikant höhere Werte auf als die Vergleichsgruppe. Diese Ergebnisse implizieren eine im Durchschnitt höhere Symptombelastung von rauchenden Alkoholpatienten im Vergleich zu nichtrauchenden Patienten. Dies impliziert eine klarere Diagnostik dieser Patientengruppe sowie das Bereitstellen von intensiveren Tabakentwöhnungsmaßnahmen für spezifische Subgruppen von Rauchern. Die Ergebnisse können als mögliche Erklärung herangezogen werden, weshalb diesen Patienten eine Aufgabe des Tabakkonsums besonders schwer fällt. Zu diskutieren bleibt die Richtung der Kausalität

Human blood plasma factors affect the adhesion kinetics of Staphylococcus aureus to central venous catheters

Staphylococcus aureus is a common cause of catheter-related blood stream infections (CRBSI). The bacterium has the ability to form multilayered biofilms on implanted material, which usually requires the removal of the implanted medical device. A first major step of this biofilm formation is the initial adhesion of the bacterium to the artificial surface. Here, we used single-cell force spectroscopy (SCFS) to study the initial adhesion of S. aureus to central venous catheters (CVCs). SCFS performed with S. aureus on the surfaces of naïve CVCs produced comparable maximum adhesion forces on three types of CVCs in the low nN range (~ 2-7 nN). These values were drastically reduced, when CVC surfaces were preincubated with human blood plasma or human serum albumin, and similar reductions were observed when S. aureus cells were probed with freshly explanted CVCs withdrawn from patients without CRBSI. These findings indicate that the initial adhesion capacity of S. aureus to CVC tubing is markedly reduced, once the CVC is inserted into the vein, and that the risk of contamination of the CVC tubing by S. aureus during the insertion process might be reduced by a preconditioning of the CVC surface with blood plasma or serum albumin

Correlational analysis for identifying genes whose regulation contributes to chronic neuropathic pain

<p>Abstract</p> <p>Background</p> <p>Nerve injury-triggered hyperexcitability in primary sensory neurons is considered a major source of chronic neuropathic pain. The hyperexcitability, in turn, is thought to be related to transcriptional switching in afferent cell somata. Analysis using expression microarrays has revealed that many genes are regulated in the dorsal root ganglion (DRG) following axotomy. But which contribute to pain phenotype versus other nerve injury-evoked processes such as nerve regeneration? Using the L5 spinal nerve ligation model of neuropathy we examined <b><it>differential </it></b>changes in gene expression in the L5 (and L4) DRGs in five mouse strains with contrasting susceptibility to neuropathic pain. We sought genes for which the degree of regulation correlates with strain-specific pain phenotype.</p> <p>Results</p> <p>In an initial experiment six candidate genes previously identified as important in pain physiology were selected for in situ hybridization to DRG sections. Among these, regulation of the Na⁺channel α subunit <it>Scn11a </it>correlated with levels of spontaneous pain behavior, and regulation of the cool receptor <it>Trpm8 </it>correlated with heat hypersensibility. In a larger scale experiment, mRNA extracted from individual mouse DRGs was processed on Affymetrix whole-genome expression microarrays. Overall, 2552 ± 477 transcripts were significantly regulated in the axotomized L5DRG 3 days postoperatively. However, in only a small fraction of these was the degree of regulation correlated with pain behavior across strains. Very few genes in the "uninjured" L4DRG showed altered expression (24 ± 28).</p> <p>Conclusion</p> <p>Correlational analysis based on in situ hybridization provided evidence that differential regulation of <it>Scn11a </it>and <it>Trpm8 </it>contributes to across-strain variability in pain phenotype. This does not, of course, constitute evidence that the others are unrelated to pain. Correlational analysis based on microarray data yielded a larger "look-up table" of genes whose regulation likely contributes to pain variability. While this list is enriched in genes of potential importance for pain physiology, and is relatively free of the bias inherent in the candidate gene approach, additional steps are required to clarify which transcripts on the list are in fact of functional importance.</p

Urticaria: Collegium Internationale Allergologicum (CIA) Update 2020.

This update on chronic urticaria (CU) focuses on the prevalence and pathogenesis of chronic spontaneous urticaria (CSU), the expanding spectrum of patient-reported outcome measures (PROMs) for assessing CU disease activity, impact, and control, as well as future treatment options for CU. This update is needed, as several recently reported findings have led to significant advances in these areas. Some of these key discoveries were first presented at past meetings of the Collegium Internationale Allergologicum (CIA). New evidence shows that the prevalence of CSU is geographically heterogeneous, high in all age groups, and increasing. Several recent reports have helped to better characterize two endotypes of CSU: type I autoimmune (or autoallergic) CSU, driven by IgE to autoallergens, and type IIb autoimmune CSU, which is due to mast cell (MC)-targeted autoantibodies. The aim of treatment in CU is complete disease control with absence of signs and symptoms as well as normalization of quality of life (QoL). This is best monitored by the use of an expanding set of PROMs, to which the Angioedema Control Test, the Cholinergic Urticaria Quality of Life Questionnaire, and the Cholinergic Urticaria Activity Score have recently been added. Current treatment approaches for CU under development include drugs that inhibit the effects of signals that drive MC activation and accumulation, drugs that inhibit intracellular pathways of MC activation and degranulation, and drugs that silence MCs by binding to inhibitory receptors. The understanding, knowledge, and management of CU are rapidly increasing. The aim of this review is to provide physicians who treat CU patients with an update on where we stand and where we will go. Many questions and unmet needs remain to be addressed, such as the development of routine diagnostic tests for type I and type IIb autoimmune CSU, the global dissemination and consistent use of PROMs to assess disease activity, impact, and control, and the development of more effective and well-tolerated long-term treatments for all forms of CU

Sharing and community curation of mass spectrometry data with Global Natural Products Social Molecular Networking

The potential of the diverse chemistries present in natural products (NP) for biotechnology and medicine remains untapped because NP databases are not searchable with raw data and the NP community has no way to share data other than in published papers. Although mass spectrometry techniques are well-suited to high-throughput characterization of natural products, there is a pressing need for an infrastructure to enable sharing and curation of data. We present Global Natural Products Social molecular networking (GNPS, http://gnps.ucsd.edu), an open-access knowledge base for community wide organization and sharing of raw, processed or identified tandem mass (MS/MS) spectrometry data. In GNPS crowdsourced curation of freely available community-wide reference MS libraries will underpin improved annotations. Data-driven social-networking should facilitate identification of spectra and foster collaborations. We also introduce the concept of ‘living data’ through continuous reanalysis of deposited data

Clinical characteristics of women captured by extending the definition of severe postpartum haemorrhage with 'refractoriness to treatment': a cohort study

Background: The absence of a uniform and clinically relevant definition of severe postpartum haemorrhage hampers comparative studies and optimization of clinical management. The concept of persistent postpartum haemorrhage, based on refractoriness to initial first-line treatment, was proposed as an alternative to common definitions that are either based on estimations of blood loss or transfused units of packed red blood cells (RBC). We compared characteristics and outcomes of women with severe postpartum haemorrhage captured by these three types of definitions. Methods: In this large retrospective cohort study in 61 hospitals in the Netherlands we included 1391 consecutive women with postpartum haemorrhage who received either ≥4 units of RBC or a multicomponent transfusion. Clinical characteristics and outcomes of women with severe postpartum haemorrhage defined as persistent postpartum haemorrhage were compared to definitions based on estimated blood loss or transfused units of RBC within 24 h following birth. Adverse maternal outcome was a composite of maternal mortality, hysterectomy, arterial embolisation and intensive care unit admission. Results: One thousand two hundred sixty out of 1391 women (90.6%) with postpartum haemorrhage fulfilled the definition of persistent postpartum haemorrhage. The majority, 820/1260 (65.1%), fulfilled this definition within 1 h following birth, compared to 819/1391 (58.7%) applying the definition of ≥1 L blood loss and 37/845 (4.4%) applying the definition of ≥4 units of RBC. The definition persistent postpartum haemorrhage captured 430/471 adverse maternal outcomes (91.3%), compared to 471/471 (100%) for ≥1 L blood loss and 383/471 (81.3%) for ≥4 units of RBC. Persistent postpartum haemorrhage did not capture all adverse outcomes because of missing data on timing of initial, first-line treatment. Conclusion: The definition persistent postpartum haemo

Politics of the precautionary principle: assessing actors' preferences in water protection policy

This paper analyzes the prospects for introducing the precautionary principle in water protection policy. In situations where a problem enters the political agenda and scientific uncertainties remain about causes or effects, political actors can justify state intervention based on the precautionary principle. It allows for public action even if risks related to the problem remain unclear. While the precautionary principle is widely applied in health and environmental policy fields all over the world, the mechanisms leading to its adoption are not fully understood. To close this gap, the paper investigates decision-makers preferences for the precautionary principle and further asks: Which factors promote political actors’ preferences for precautionary policy measures? In order to answer this question we study the case of emerging micropollutants—a water quality issue that recently entered political agendas, where many uncertainties remain about sources and effects. We rely on data gathered through a standardized survey among the political elite in Switzerland, which represents one of the first countries that adopted policy measures to reduce micropollutants in water bodies, despite the uncertainties that remain. Results analyzed through a temporal network autocorrelation model reveal that actors embedded in collaborative governance arrangements have the tendency to prefer precautionary action. Certain aspects of policy design, such as problem prioritization and target group membership, also impact the prospects for introducing the precautionary principle