Direktdemokratisches Layering mit sozialer Schlagseite? Privatisierung und Kommunalisierung bei Begehren und Entscheiden

Eigentumsfragen bei Infrastrukturen und Dienstleistungen im öffentlichen Interesse waren seit Mitte der 1980er Jahre Thema direktdemokratischer Begehren und Entscheide. Deren Häufigkeit wird hier in Beziehung zu den Privatisierungs- und Kommunalisierungsaktivitäten in den deutschen Ländern und Kommunen gesetzt. Zwei Ergebnisse zeigen sich: Wenn über Privatisierung abgestimmt wird, dann wird sie weit überwiegend abgelehnt. Somit wird der Befund der politikwissenschaftlichen Privatisierungsforschung bestätigt, dass Begehren und Entscheide als Veto-Positionen fungieren können. Im Abgleich mit dem Umfang der Privatisierungs- und Kommunalisierungsaktivitäten zeigt sich jedoch auch, dass gegen Privatisierung in geringem Maße politisch mobilisiert wird. Die Salienz des Issues reicht weit überwiegend nicht hin, um direktdemokratische Begehren und Entscheide zu initiieren. Dies wird mit den geringen Kapazitäten von Milieus erklärt, die von Privatisierungsentscheidungen negativ betroffen sind (sozialer Bias), und mit institutionellen Restriktionen für entsprechende Initiativen. Der Artikel trägt zur Forschung über direkte Demokratie in Regierungssystemen bei, in denen direktdemokratische Verfahren institutionell angelagert werden (Layering).Ownership issues of infrastructures and services in the public interest have been the subject of direct-democratic initiatives and decisions since the mid-1980s. Their frequency is related to privatization and municipalization activities in the German states and municipalities. Two results stand out: When privatization is put to a vote, it is overwhelmingly rejected. This confirms the finding of political science research on privatization that direct democracy can act as a veto position. However, a comparison with the scope of privatization and municipalization activities also shows that there is little political mobilization against privatization. For the most part, the salience of the issue is not sufficient to initiate direct-democratic decisions. This is explained by the low capacities of milieus that are negatively affected by privatization decisions (social bias) and by institutional restrictions on initiatives. The article contributes to research on direct democracy in government systems in which direct democratic procedures are institutionally layered

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

SARS-CoV-2 Omicron is an immune escape variant with an altered cell entry pathway

Vaccines based on the spike protein of SARS-CoV-2 are a cornerstone of the public health response to COVID-19. The emergence of hypermutated, increasingly transmissible variants of concern (VOCs) threaten this strategy. Omicron (B.1.1.529), the fifth VOC to be described, harbours multiple amino acid mutations in spike, half of which lie within the receptor-binding domain. Here we demonstrate substantial evasion of neutralization by Omicron BA.1 and BA.2 variants in vitro using sera from individuals vaccinated with ChAdOx1, BNT162b2 and mRNA-1273. These data were mirrored by a substantial reduction in real-world vaccine effectiveness that was partially restored by booster vaccination. The Omicron variants BA.1 and BA.2 did not induce cell syncytia in vitro and favoured a TMPRSS2-independent endosomal entry pathway, these phenotypes mapping to distinct regions of the spike protein. Impaired cell fusion was determined by the receptor-binding domain, while endosomal entry mapped to the S2 domain. Such marked changes in antigenicity and replicative biology may underlie the rapid global spread and altered pathogenicity of the Omicron variant

Multiorgan MRI findings after hospitalisation with COVID-19 in the UK (C-MORE): a prospective, multicentre, observational cohort study

Introduction: The multiorgan impact of moderate to severe coronavirus infections in the post-acute phase is still poorly understood. We aimed to evaluate the excess burden of multiorgan abnormalities after hospitalisation with COVID-19, evaluate their determinants, and explore associations with patient-related outcome measures. Methods: In a prospective, UK-wide, multicentre MRI follow-up study (C-MORE), adults (aged ≥18 years) discharged from hospital following COVID-19 who were included in Tier 2 of the Post-hospitalisation COVID-19 study (PHOSP-COVID) and contemporary controls with no evidence of previous COVID-19 (SARS-CoV-2 nucleocapsid antibody negative) underwent multiorgan MRI (lungs, heart, brain, liver, and kidneys) with quantitative and qualitative assessment of images and clinical adjudication when relevant. Individuals with end-stage renal failure or contraindications to MRI were excluded. Participants also underwent detailed recording of symptoms, and physiological and biochemical tests. The primary outcome was the excess burden of multiorgan abnormalities (two or more organs) relative to controls, with further adjustments for potential confounders. The C-MORE study is ongoing and is registered with ClinicalTrials.gov, NCT04510025. Findings: Of 2710 participants in Tier 2 of PHOSP-COVID, 531 were recruited across 13 UK-wide C-MORE sites. After exclusions, 259 C-MORE patients (mean age 57 years [SD 12]; 158 [61%] male and 101 [39%] female) who were discharged from hospital with PCR-confirmed or clinically diagnosed COVID-19 between March 1, 2020, and Nov 1, 2021, and 52 non-COVID-19 controls from the community (mean age 49 years [SD 14]; 30 [58%] male and 22 [42%] female) were included in the analysis. Patients were assessed at a median of 5·0 months (IQR 4·2–6·3) after hospital discharge. Compared with non-COVID-19 controls, patients were older, living with more obesity, and had more comorbidities. Multiorgan abnormalities on MRI were more frequent in patients than in controls (157 [61%] of 259 vs 14 [27%] of 52; p<0·0001) and independently associated with COVID-19 status (odds ratio [OR] 2·9 [95% CI 1·5–5·8]; padjusted=0·0023) after adjusting for relevant confounders. Compared with controls, patients were more likely to have MRI evidence of lung abnormalities (p=0·0001; parenchymal abnormalities), brain abnormalities (p<0·0001; more white matter hyperintensities and regional brain volume reduction), and kidney abnormalities (p=0·014; lower medullary T1 and loss of corticomedullary differentiation), whereas cardiac and liver MRI abnormalities were similar between patients and controls. Patients with multiorgan abnormalities were older (difference in mean age 7 years [95% CI 4–10]; mean age of 59·8 years [SD 11·7] with multiorgan abnormalities vs mean age of 52·8 years [11·9] without multiorgan abnormalities; p<0·0001), more likely to have three or more comorbidities (OR 2·47 [1·32–4·82]; padjusted=0·0059), and more likely to have a more severe acute infection (acute CRP >5mg/L, OR 3·55 [1·23–11·88]; padjusted=0·025) than those without multiorgan abnormalities. Presence of lung MRI abnormalities was associated with a two-fold higher risk of chest tightness, and multiorgan MRI abnormalities were associated with severe and very severe persistent physical and mental health impairment (PHOSP-COVID symptom clusters) after hospitalisation. Interpretation: After hospitalisation for COVID-19, people are at risk of multiorgan abnormalities in the medium term. Our findings emphasise the need for proactive multidisciplinary care pathways, with the potential for imaging to guide surveillance frequency and therapeutic stratification

Review of tufa deposition and palaeohydrological conditions in the White Peak, Derbyshire UK : implications for Quaternary landscape evolution

This review considers the geological and geomorphological context of tufa barrages that occupy buried valley settings in the Wye catchment, Derbyshire. It describes the potential relationship of the tufa with locations of hypothesised river captures and inception horizon-guided groundwater flow paths. Tufa barrage development is associated with steps in the bedrock, which may be related to knick-point recession during river capture. Broad estimates of valley incision have been calculated from previously dated deposits. These support current interpretations of particularly significant effective base-level lowering during the Anglian and Devensian stages of the Quaternary and have the potential to add to the knowledge of regional uplift histories

The influence of land use and management on soil carbon levels for crop-pasture systems in Central New South Wales, Australia

Changes in land use and management have been proposed as a way to increase soil organic carbon (SOC) in crop and pasture systems. Some of the proposed activities to improve SOC are the introduction of pasture phases in cropping systems, stubble retention, no-till cropping, improved fertilisation, introduction of more productive pasture species and grazing management. There is also growing interest in novel farming systems, such as pasture cropping (intercropping cereal crops with established perennial pastures), which may improve SOC. However, there have been few broad scale surveys to determine whether these land management changes have an impact on commercial farms. In this study, comparisons of land use were established for mixed farming and pasture cropping systems in the slopes region (average annual rainfall: 500-650mm) and for cropping and pasture in the plains region (average annual rainfall: 300-500mm) of Central West NSW, Australia. The survey aimed to determine the difference in SOC stocks (Mg C ha-1) and the composition of three soil organic carbon fractions (particulate - POC, humus - HUM and resistant - ROC). The influences of management actions and pasture composition were also assessed across pasture and cropping land uses. Cropping systems had lower SOC stocks in the soil than pasture systems in each region, but pasture cropping was not different from perennial pasture. Generally, there were larger differences in the POC due to land use and management than the other SOC fractions. Management practices in cropping systems explained greater variability in SOC than in pastures. For cropping systems, higher amounts of P fertiliser were associated with higher SOC, POC and ROC while higher amounts of N fertiliser were associated with lower SOC, POC and ROC. For pastures, the proportion of bare ground was associated with lower SOC and POC. These associations indicate there is an opportunity to increase SOC by converting cropping land to permanent pasture, increasing the frequency of pasture phases, changing crop fertiliser regimes and reducing bare ground in pastures, but further work is needed to verify the causality behind these associations

Mobile Zoos and Other Itinerant Animal Handling Events: Current Status and Recommendations for Future Policies

Mobile zoos are events in which non-domesticated (exotic) and domesticated species are transported to venues such as schools, hospitals, parties, and community centres, for the purposes of education, entertainment, or social and therapeutic assistance. We conducted literature searches and surveyed related government agencies regarding existing provisions within laws and policies, number of mobile zoos, and formal guidance issued concerning operation of such events in 74 countries or regions. We also examined governmental and non-governmental guidance standards for mobile zoos, as well as websites for mobile zoo operations, assessed promotional or educational materials for scientific accuracy, and recorded the diversity of species in use. We used the EMODE (Easy, Moderate, Difficult, or Extreme) algorithm, to evaluate identified species associated with mobile zoos for their suitability for keeping. We recorded 14 areas of concern regarding animal biology and public health and safety, and 8 areas of false and misleading content in promotional or educational materials. We identified at least 341 species used for mobile zoos. Mobile zoos are largely unregulated, unmonitored, and uncontrolled, and appear to be increasing. Issues regarding poor animal welfare, public health and safety, and education raise several serious concerns. Using the precautionary principle when empirical evidence was not available, we advise that exotic species should not be used for mobile zoos and similar itinerant events

Historical Datasets Support Genomic Selection Models for the Prediction of Cotton Fiber Quality Phenotypes Across Multiple Environments

Genomic selection (GS) has successfully been used in plant breeding to improve selection efficiency and reduce breeding time and cost. However, there has not been a study to evaluate GS prediction models that may be used for predicting cotton breeding lines across multiple environments. In this study, we evaluated the performance of Bayes Ridge Regression, BayesA, BayesB, BayesC and Reproducing Kernel Hilbert Spaces regression models. We then extended the single-site GS model to accommodate genotype × environment interaction (G×E) in order to assess the merits of multi- over single-environment models in a practical breeding and selection context in cotton, a crop for which this has not previously been evaluated. Our study was based on a population of 215 upland cotton (Gossypium hirsutum) breeding lines which were evaluated for fiber length and strength at multiple locations in Australia and genotyped with 13,330 single nucleotide polymorphic (SNP) markers. BayesB, which assumes unique variance for each marker and a proportion of markers to have large effects, while most other markers have zero effect, was the preferred model. GS accuracy for fiber length based on a single-site model varied across sites, ranging from 0.27 to 0.77 (mean = 0.38), while that of fiber strength ranged from 0.19 to 0.58 (mean = 0.35) using randomly selected sub-populations as the training population. Prediction accuracies from the M×E model were higher than those for single-site and across-site models, with an average accuracy of 0.71 and 0.59 for fiber length and strength, respectively. The use of the M×E model could therefore identify which breeding lines have effects that are stable across environments and which ones are responsible for G×E and so reduce the amount of phenotypic screening required in cotton breeding programs to identify adaptable genotypes

Psychosocial variables are related to future exacerbation risk and perinatal outcomes in pregnant women with asthma

Objective: To determine the relationship between psychosocial variables, future exacerbation risk during pregnancy, and perinatal outcomes. Methods: A secondary analysis of a randomized controlled trial of exhaled nitric oxide versus guideline-based treatment adjustment in pregnant women with asthma. Women were recruited between 12 and 20 weeks gestation and monitored for the remainder of the pregnancy. Psychosocial questionnaires including the Perceived Control of Asthma Questionnaire, the Brief Illness Perception Questionnaire, and the Six-Item Short-Form State Trait Anxiety Inventory were assessed at randomization. Exacerbations were defined as hospitalization, emergency visit, unscheduled doctor visit, or oral corticosteroid use for worsening asthma. Perinatal outcomes included preterm birth, small for gestational age, and cesarean section. Multiple logistic regressions were performed with predictor variables, including demographics and psychosocial and clinical variables. Results: The 175 participants had a mean (SD) age = 28.5(5.4) years, forced expiratory volume in 1 second (FEV1%) predicted = 95.9(13.4), and asthma control score = 0.88(0.70). Greater perceived control of asthma reduced the odds of subsequent exacerbation (odds ratio (OR) [95%CI] 0.92 [0.85, 0.98], p = .016), cesarean without labor (0.84 [0.75, 0.94], p = .003), and preterm birth (0.84 [0.72, 0.97], p = .019), while increased anxiety increased the odds of subsequent exacerbation (1.05 [1.01, 1.08], p = .008). Conclusion: Women’s perceptions of asthma control and their psychosocial state (anxiety) are related to future exacerbation risk, cesarean section, and preterm birth