New aspects of the diagnosis of Helicobacter pylori infection

Aims: Helicobacter pylori infection, although the prevalence is declining in Western world, is still responsible for several clinically important diseases. None of the diagnostic tests is perfect and in this study, the performance of three stool antigen tests was assessed. In areas of high H. pylori prevalence, the definition of patients with the greatest benefit from eradication therapy may be a problem; the role of duodenal gastric metaplasia in categorizing patients at risk for duodenal ulcer was evaluated in this respect. Whether persistent chronic inflammation and elevated H. pylori antibodies after successful eradication are associated with each other or with atrophic gastritis, a long term sequelae of H. pylori infection, were also studied. Patients and methods: The three stool antigen tests were assessed in pre- and post-eradication settings among 364 subjects in two studies as compared to the rapid urease test (RUT), histology, culture, the 13C-urea breath test (UBT) and enzyme immunoassay (EIA) based H. pylori serology. The association between duodenal gastric metaplasia with duodenal ulcer was evaluated in a retrospective study including 1054 patients gastroscopied due to clinical indications and 154 patients previously operated for duodenal ulcer. The extent of duodenal gastric metaplasia was assessed from histological specimens in different patient groups formed on the basis of gastroscopy findings and H. pylori infection. Chronic gastric inflammation (108 patients) and H. pylori antibodies and serum markers for atrophy (77 patients) were assessed in patients earlier treated for H. pylori. Results: Of the stool antigen tests studied, the monoclonal antibody-based EIA-test showed the highest sensitivity and specificity both in the pre-treatment setting (96.9% and 95.9%) and after therapy (96.9% and 97.8%). The polyclonal stool antigen test and the in-office test had at baseline a sensitivity of 91% and 94%, and a specificity of 96% and 89%, respectively and in a post-treatment setting, a sensitivity of 78% and 91%, and a specificity of 97%, respectively. Duodenal gastric metaplasia was strongly associated with H. pylori positive duodenal ulcer (odds ratio 42). Although common still five years after eradication, persistent chronic gastric inflammation (21%) and elevated H. pylori antibodies (33%) were neither associated with each other nor with atrophic gastritis. Conclusions: Current H. pylori infection can feasibly be diagnosed by a monoclonal antibody-based EIA test with the accuracy comparable to that of reference methods. The performance of the polyclonal test as compared to the monoclonal test was inferior especially in the post-treatment setting. The in-office test had a low specificity for primary diagnosis and hence positive test results should probably be confirmed with another test before eradication therapy is prescribed. The presence of widespread duodenal gastric metaplasia showed promising results in detecting patients who should be treated for H. pylori due to an increased risk of duodenal ulcer. If serology is used later on in patients with earlier successfully treated for H. pylori, it should be taken into account that H. pylori antibodies may persist elevated for years for unknown reason. However, this phenomenon was not found to be associated with persistent chronic inflammation or atrophic changes.

Ethics of Justification : A Defence of Contractualism

In What We Owe to Each Other, T.M. Scanlon formulated a new version of the ethical theory called contractualism. This theory took reasons considerations that count in favour of judgment-sensitive attitudes to be the fundamental normative notion. It then used normative reasons to first account for evaluative properties. For an object to be valuable, on this view, is for it to have properties that provide reasons to have favourable attitudes towards the bearer of value. Scanlon also used reasons to account for moral wrongness. His contractualism claims that an act is morally wrong if it is forbidden by any set of moral principles that no one could reasonably reject. My thesis consists of five previously published articles which attempt to clarify Scanlon s theory and to defend it against its critics. The first article defends the idea that normative reason-relations are fundamental against Joshua Gert. Gert argues that rationality is a more basic notion than reasons and that reasons can be analysed in terms of their rationally requiring and justifying dimensions. The second article explores the relationship between value and reasons. It defends Scanlon s view according to which reasons are the more basic than value against those who think that reasons are based on the evaluative realm. The last three articles defend Scanlon s views about moral wrongness. The first one of them discusses a classic objection to contractualist theories. This objection is that principles which no one could reasonably reject are redundant in accounting for wrongness. This is because we need a prior notion of wrongness to select those principles and because such principles are not required to make actions wrong or to provide reasons against wrong actions. The fourth article explores the distinctive reasons which contractualists claim there are for avoiding the wrong actions. The last article argues against the critics of contractualism who claim that contractualism has implausible normative consequences for situations related to the treatment of different-sized groups of people.

Paganism, Traditionalism, Nationalism : Narratives of Russian Rodnoverie

The topic of this dissertation is Rodnoverie, a religion that revives pre-Christian Slavic spirituality. Rodnoverie has been noted to be one of the fastest growing new religions in Russia and the aim of the study is to analyse why and how the movement has attained its popularity. First, the analysis asks how Rodnovers themselves explain the revival of ancient Paganism at this particular historical moment. Secondly, these interpretations are reflected in the framework of sociological discussions about contemporary religiosity. The analysis discusses how the Rodnoverie movement corresponds to some tendencies that are considered to characterise late modern religiosity. The primary material of the research is Rodnoverie texts: books, newspapers and electronic articles. The published literature is supplemented by fieldwork material which includes interviews with some Rodnoverie leaders and the author s participant observation of rituals and gatherings. Methodologically, the study draws on a sociological narrative approach that is focused on examining how individuals and groups use narratives to construct their identities and to challenge mainstream discussions and interpretations. The analysis discerns three narratives. The first one of these portrays Rodnoverie as a revival of the native Russian or Slavic religion. The narrative provides a new version of the old Slavophile idea, according to which imitation of the West has misguided Russia and, therefore, Russians should turn to their own tradition. In the second narrative, Rodnoverie is presented as a nature religion that features tolerance and pluralistic values. According to these perceptions, the emergence of Rodnoverie marks the dead-end of the earlier hegemonic universalistic world-views, the mono-ideologies . While the nationalist narrative focuses on Russia s national heritage, the third narrative interprets the tradition in more universal terms as an alternative to modern values and way of life. The main argument of this narrative is that contemporary people have become alienated from nature, their roots and their community. The themes that are discussed in the theoretical literature on late modern religiosity often configure in Rodnovers interpretations either directly or when looked at through an analytical framework. Of the various themes that are addressed in a sociological study of religion the ones that have most relevance for Rodnoverie are the discussions on individualisation, globalisation and secularisation. Rodnoverie reflects such tendencies as the subjectivisation of religion and the modern crisis of authority. The movement also both exemplifies and actively promotes religious pluralisation in Russia.

Tsoi Yuen Resistance and Post-80s Generation: A new wave of domestic social movement

Hong Kong was once a British colony and has been under the sovereignty of People’s Republic of China (PRC) since 1997. However, some of the unjust practices and colonial legacies are infiltrated into the development ideology as well as the social structures. The construction of intercity express railway project announced in 2008 causing the demolishment of Tsoi Yuen Tsuen, a “non-indigenous” agricultural village in Hong Kong, was one of the current examples. Tsoi Yuen village was established under the former colonial sovereignty sixty years ago. Approximately 450 populations were affected that they had to relocate their homeland involuntarily. However, these villagers were very attached to their homelands and were unwilling to move, and meanwhile they found that they were absent in the government’s consultation and decision-making process. Soon they began their resistance and demanded for “No Move! No Demolish!”. Their movement was strongly supported by a group of “Post-80s generation” and turned into the most important social movement of the city in recent years. In fact, demolition of Tsoi Yuen Village for city development is not an isolated case in the city. Meanwhile the situation is getting worse in Mainland China. I chose the case study of Tsoi Yuen Resistance from 2008 to 2011 for revelation of the complicated colonial history and postcolonial era of Hong Kong. I focused on discussing the Tsoi Yuen Resistance and the Post-80s movement, and how they have exposed the tension between top-down urban planning and development and public movements fighting for a more democratic process in choosing their way of living. Through the study of a village movement which as well as the rationale behind the Post-80s’ support, I hoped to illustrate how this movement has awaken a different sense of living for the new generations in the midst of the high-sounding urban development. It is an opportunity to examine Hong Kong’s colonial epoch in a different perspective: through studying the Tsoi Yuen Village, let them (subalterns) speak for themselves. Furthermore, the significance of this resistance, taking place eleven years after the handover to the PRC, is an important fact that I shall not miss in later discussion. Last but not least, during the resistance, advanced technology and social networks such as Facebook, Twitter, iPhone were used by Post 80s generation to spread the latest information in order to attract public’s concern and participation. Therefore, apart from studying Tsoi Yuen Resistance as a local social movement, I also regard it as a part of the global movement in perusing ecological lifestyle and civil society. How Post 80s’ generation manipulates the global idea in a local context will also be examined.

A New Definition of A Priori Knowledge: In Search of a Modal Basis

In this paper I will offer a novel understanding of a priori knowledge. My claim is that the sharp distinction that is usually made between a priori and a posteriori knowledge is groundless. It will be argued that a plausible understanding of a priori and a posteriori knowledge has to acknowledge that they are in a constant bootstrapping relationship. It is also crucial that we distinguish between a priori propositions that hold in the actual world and merely possible, non-actual a priori propositions, as we will see when considering cases like Euclidean geometry. Furthermore, contrary to what Kripke seems to suggest, a priori knowledge is intimately connected with metaphysical modality, indeed, grounded in it. The task of a priori reasoning, according to this account, is to delimit the space of metaphysically possible worlds in order for us to be able to determine what is actual.

Nomenclatural corrections in Mesoamerican Plantaginaceae and a new species of Tetranema from Honduras

Study of the Plantaginaceae for the Flora Mesoamericana project has resulted in five lectotypifications, a new combination in Rhodochiton, and the discovery of a new species of Tetranema from Honduras. This species, Tetranema michaelfayanum, is described here, a key to the species of Tetranema is provided, and the T. roseum complex is discussed.

New combinations of the fern genus Tectaria (Tectariaceae) for the Flora of China.

For studies on the fern family Tectariaceae for the Flora of China, four species previously treated as Ctenitopsis need new combinations in Tectaria. The new combinations are proposed here and information on their types is provided.